Transcatheter embolization of a patent ductus arteriosus (PDA) is a commonly performed minimally invasive cardiovascular intervention in dogs. Prophylactic antibiotics are routinely administered in the perioperative period to prevent implant-related bacterial endocarditis. Because of the worldwide increasing issue of antibiotic resistance, the question arises whether routine administration of prophylactic antibiotics is evidence-based.

The present retrospective case series included client-owned dogs that underwent a transcatheter embolization of their PDA at the author's clinic between 2004 and 2016. Further inclusion criteria were that the author had to be either the primary or the supervising surgeon, at least 3 months of follow-up information had to be available, at least one metal implant had to be delivered in the PDA, and no local or systemic antibiotics were given on the day of the intervention and the week thereafter. Follow-up information was gained either via telephone interview with the owner or with the referring veterinarian, or via re-check examinations at the author's clinic.

In total 54 dogs fulfilled the inclusion criteria. The occlusion devices were detachable coils in 18 dogs, Amplatz canine ductal occluders (ACDO) in 35 dogs and a human Ampatzer duct occluder in 1 dog. All coils and ACDOs were implanted via the femoral artery with the dogs under general anesthesia under fluoroscopic guidance. The median age of the dogs at surgery was 4 months (range 2–95 months) and their median weight was 7.5 kg (range 1.9–35.7 kg). An immediate closure of the PDA was reached in 36 dogs. The median length of the procedure was 100 minutes (range 45–192 minutes). The median length of the follow-up was 25 months (range 3–157 months).

None of the dogs developed clinical signs that could be compatible with bacterial endocarditis within 3 months after the PDA-occlusion.

The most important weakness of the present study is its retrospective nature. Another weakness is that in the majority of cases the follow-up information was gained via telephone interview. However, bacterial endocarditis is a life-threating condition, which would not cause only mild symptoms. Though the 3 months follow-up might look arbitrarily chosen, several veterinary and humans studies use the same cut-off. Moreover, a longer incubation period is very unlikely, if bacteria are assumed to enter the circulation during surgery.

The findings of the present study are in line with the most recent human recommendations, which do not recommend the routine use of prophylactic antibiotics at transcatheter PDA-embolization.

Disclosures

No disclosures to report.