This 12 year old dog was dying of Heartworm Caval Syndrome.  After 2 days of supportive care, and watching the dog go down hill, I decided I had nothing to lose by trying to remove the big wad of heartworms that I could see in the Right atrium on ultrasound.

After ligating the right jugular vein and incising a longitudinal cut in the vein I passed my endoscopic basket forcep.  After blindly coming up empty 4-5 times, I went deeper and came up with this wad of worms.  All of the worms came out with this one grab.  There were 25 in all and nothing showed up on post op ultrasound.  It was amazing that they all stuck together so easily and the basket could get every single one.  I'm not sure why anyone would want to use an alligator forcep which would potentially damage the valve.  This was all done with a local anesthetic around the jugular.

Unfortunately the dog died of oliguric renal failure a couple days later.  Next time I will try this immediately.

Chris Holmes, DVM