Implant of a Port-a-Cath device in the pericardium of a dog for the management of malignant pericardial effusion produced by a cardiac hemangiosarcoma

Abstract

Although its use is only indicated for access to central veins in human medicine, we describe the implantation of a Port-a-Cath device in the pericardial space of a female German Sheperd dog. This patient was diagnosed with a hemangiosarcoma in the right  atrial wall and as a result of the pericardial effusion the dog suffered signs of cardiac tamponade prior to the implantation of the device. The technique supposed a medium surgical difficulty and offered  percutaneous  access  to the pericardial cavity  permanently   both for the aspiration of the effusion and for the administration of Cisplatin, which was administered in a single dose 7 days after implantation. Weekly controls of permeability and positioning of the device were carried out, without verifying pericardial effusion until day 52 after implantation, in which the patient began to collect amounts of fluid with a range of 15 to 50 ml. This was aspirated with intervals of 3 to 5 days until the animal was compassionately euthanized on day 68. The Port-a-Cath device remained permeable, there were no complications associated with it, nor migrations into the pleural cavity. Once the patient was euthanized, a thoracotomy was performed in order to have the final histopathology diagnosis in which hemangiosarcoma was confirmed. The existence of multiple metastasis in the lungs, rest of the heart, pericardium and subcutaneous tissue, and the symptoms associated with dyspnea at rest, helped to conclud that the patient did not die from cardiac tamponade, but from the tumor and its metastasis. The implantation of a Port-a-Cath device proved to be an alternative for the prevention of malignant cardiac tamponade in this canine patient.