Hillsborough Veterinary Referrals delivers life-saving transatrial stenting through multi-specialist collaboration
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In a showcase of interventional excellence and network-wide synergy, the specialist-led cardiology team at Hillsborough Veterinary Referrals successfully resolved a complex case of Budd-Chiari syndrome in a nine-year-old Soft-Coated Wheaten Terrier named Barney.

Presenting with a three-month history of refractory ascites, Barney was referred to Cardiology Specialist Julie Hamilton Elliott, whose investigations revealed a large 4x3.7cm cardiac mass located between the right and left atrium. This mass was causing significant compression of the caudal vena cava as it entered the right atrium, leading to the severe hepatic venous congestion and fluid accumulation that had previously failed to respond to medical management.

To address this life-threatening obstruction, the specialist team at Hillsborough opted for a minimally invasive, fluoroscopic-guided transatrial stent procedure. This highly technical intervention involved accessing both the right jugular and left femoral veins to perform a contrast angiographic study, which mapped the exact extent of the neoplastic vascular obstruction. Using a series of specialised catheters and guidewires, the team successfully deployed a woven Nitinol stent through the right atrium, creating a patent channel from the caudal to the cranial vena cava.

Repeat angiography confirmed immediate restoration of flow and, thanks to the specialist care he received, Barney made a seamless recovery and was fit for discharge to his owners just 24 hours after the procedure, highlighting the huge benefits of this minimally invasive approach.

This successful outcome was made possible by a significant collaborative effort across the CVS network. The team at Hillsborough collaborated extensively with cardiology Specialists Kieran Borgeat (Bristol Veterinary Specialists) and Liz Bode (ChesterGates Veterinary Specialists), alongside anaesthesia support from Specialist Anaesthetist Delphine Holopherne-Doran (Bristol Veterinary Specialists) and diagnostic imaging consultation with Nuria Corzo-Menendez (VetOracle Teleradiology). This CVS-wide support was instrumental in delivering this high-level intervention for Barney.

At his two-week re-evaluation, Barney showed a complete resolution of his ascites and a return to his normal self, with thoracic radiographs confirming the stable position of the stent.

Julie Hamilton Elliott, lead referral vet at Hillsborough, noted:

It was extremely rewarding to successfully relieve Barney’s clinical signs through transatrial stenting as his quality of life was rapidly declining. Despite the complexity of the procedure, he was able to return to his owners the following day. This highlights one of the major benefits of interventional cardiology – in experienced hands, we can offer a minimally invasive, low pain procedure with rapid recovery for many patients
While long-term complications such as stent migration or thromboembolic events remain a possibility, Barney’s case demonstrates how specialist expertise can offer an excellent palliative option for patients with obstructive heart base masses. Hillsborough continues to offer this and other advanced interventional procedures—including pacemaker implantation, PDA occlusion, and balloon valvuloplasty—as part of its comprehensive cardiology service.