Anomalous broncho-oesophageal arteries and peripheral systemic-to-pulmonary connections in an asymptomatic puppy

A clinically healthy four-month-old puppy had a grade 2/6 left basilar, continuous heart murmur and was presented for further evaluation. Echocardiography revealed multiple small diastolic colour signals around the main right pulmonary artery. Mild pulmonary overcirculation and left ventricular enlargement were observed on thoracic radiography. Contrast enhanced CT with angiography revealed anomalous broncho-oesophageal arteries with peripheral pulmonary shunting, consistent with systemic-to-pulmonary connections. Six months after diagnosis, the patient continued to lack clinical signs, had no progression in left atrial or left ventricular size, and there was no progression in pulmonary overcirculation. This report shows that dogs with congenital anomalous broncho-oesophageal arteries and mild-to-moderate peripheral pulmonary shunting can remain asymptomatic over a long period of time.