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Diaz DM, Orton EC, de Rezende ML, Zersen K, Guillaumin J. Assessment of microcirculation variables and endothelial glycocalyx using sidestream dark field videomicroscopy in anesthetized dogs undergoing cardiopulmonary bypass. Front Vet Sci 2023; 10:1189738. [PMID: 37671279 PMCID: PMC10476349 DOI: 10.3389/fvets.2023.1189738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 07/06/2023] [Indexed: 09/07/2023] Open
Abstract
Introduction To evaluate microcirculation and endothelial glycocalyx (eGC) variables using sidestream darkfield (SDF) videomicroscopy in canine cardiopulmonary bypass (CPB). Methods Dogs undergoing CPB for surgical correction of naturally-occurring cardiac disease were prospectively included. Variables collected included patient demographics, underlying cardiac disease, red blood cell flow (Flow), 4-25 μm vessel density (Density), absolute capillary blood volume (CBVabs), relative capillary blood volume (CBVrel) and eGC width assessed by perfused boundary region (PBR). Anesthetized healthy dogs were used as control. Microcirculation and eGC variables were compared at baseline under anesthesia (T0), on CPB prior to cross clamping (T1), after cross clamp removal following surgical correction (T2) and at surgical closure (T3). Results Twelve dogs were enrolled, including 10 with a complete dataset. Median Flow was 233.9, 79.9, 164.3, and 136.1 μm/s at T0, T1, T2, and T3, respectively, (p = 1.00). Median Density was 173.3, 118.4, 121.0 and 155.4 mm/mm2 at T0, T1, T2, and T3, respectively, (p = 1.00). Median CBVabs decreased over time: 7.4, 6.6, 4.8 and 4.7 103μm3 at T0, T1, T2, and T3, respectively, (p < 0.01). Median CBVrel increased over time: 1.1, 1.5,1.1, and 1.3 103μm3 at T0, T1, T2, and T3, respectively, (p < 0.001). Median PBR increased over time: 1.8, 2.1, 2.4, 2.1 μm at T0, T1, T2, and T3, respectively, (p < 0.001). Compared to control dogs (n = 8), CPB dogs had lower CBVabs at T0. Conclusion Alterations in eGC thickness and microvascular occur in dogs undergoing CPB for naturally-occurring cardiac disease.
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Affiliation(s)
| | | | | | | | - Julien Guillaumin
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
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Katsburg M, Weingart C, Aubry E, Kershaw O, Kikhney J, Kursawe L, Lübke-Becker A, Moter A, Skrodzki M, Kohn B, Fulde M. Limiting Factors in Treatment Success of Biofilm-Forming Streptococci in the Case of Canine Infective Endocarditis Caused by Streptococcus canis. Vet Sci 2023; 10:vetsci10050314. [PMID: 37235397 DOI: 10.3390/vetsci10050314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/12/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
An 8-year-old male Rhodesian Ridgeback was presented with fever and severe thrombocytopenia. Clinical and laboratory examination, echocardiography, blood culture, and pathohistology revealed evidence of infective endocarditis, ischemic renal infarcts, and septic encephalitis. Treatment was started immediately but the dog's condition worsened, and the dog had to be euthanized. The causative Streptococcus canis strain was detected by blood culture and MALDI-TOF MS and analyzed using whole-genome sequencing and multilocus sequence typing. Antibiotic susceptibility testing did not detect any resistance. The affected heart valve was analyzed using FISH imaging, which showed a streptococcal biofilm on the heart valve. Bacteria in biofilms are recalcitrant to antibiotic treatment. Early diagnosis could be beneficial to treatment outcome. Treatment of endocarditis could be improved by researching the optimal dosage of antibiotics in conjunction with the use of biofilm-active drugs.
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Affiliation(s)
- Miriam Katsburg
- Institute for Microbiology and Epizootics, Freie Universität Berlin, Robert-von-Ostertagstr. 7, 14163 Berlin, Germany
- Veterinary Centre for Resistance Research (TZR), Freie Universität Berlin, 14163 Berlin, Germany
| | - Christiane Weingart
- Small Animal Clinic, Freie Universität Berlin, Oertzenweg 19b, 14163 Berlin, Germany
| | - Etienne Aubry
- Institute for Microbiology and Epizootics, Freie Universität Berlin, Robert-von-Ostertagstr. 7, 14163 Berlin, Germany
- Veterinary Centre for Resistance Research (TZR), Freie Universität Berlin, 14163 Berlin, Germany
| | - Olivia Kershaw
- Institute of Veterinary Pathology, Freie Universität Berlin, Robert-von-Ostertagstr. 15, 14163 Berlin, Germany
| | - Judith Kikhney
- Biofilmcenter, Department for Microbiology, Infectious Diseases and Immunology, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany
- MoKi Analytics GmbH, Marienplatz 9, 12207 Berlin, Germany
| | - Laura Kursawe
- Biofilmcenter, Department for Microbiology, Infectious Diseases and Immunology, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany
- MoKi Analytics GmbH, Marienplatz 9, 12207 Berlin, Germany
| | - Antina Lübke-Becker
- Institute for Microbiology and Epizootics, Freie Universität Berlin, Robert-von-Ostertagstr. 7, 14163 Berlin, Germany
- Veterinary Centre for Resistance Research (TZR), Freie Universität Berlin, 14163 Berlin, Germany
| | - Annette Moter
- Biofilmcenter, Department for Microbiology, Infectious Diseases and Immunology, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany
- MoKi Analytics GmbH, Marienplatz 9, 12207 Berlin, Germany
- Moter Diagnostics, Marienplatz 9, 12207 Berlin, Germany
| | - Marianne Skrodzki
- Small Animal Clinic, Freie Universität Berlin, Oertzenweg 19b, 14163 Berlin, Germany
| | - Barbara Kohn
- Small Animal Clinic, Freie Universität Berlin, Oertzenweg 19b, 14163 Berlin, Germany
| | - Marcus Fulde
- Institute for Microbiology and Epizootics, Freie Universität Berlin, Robert-von-Ostertagstr. 7, 14163 Berlin, Germany
- Veterinary Centre for Resistance Research (TZR), Freie Universität Berlin, 14163 Berlin, Germany
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Gordon-Evans WJ, Montin KH, Ober CP, Coryell JL, Castilla AE. Canine mitral valve size as measured by computed tomography. Am J Vet Res 2022; 83:ajvr.22.05.0085. [DOI: 10.2460/ajvr.22.05.0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
OBJECTIVE
To measure the mitral annulus in dogs. Our hypothesis was that mitral measurement would be possible and consistent among observers using CT.
SAMPLE
Thoracic CT scans of dogs without known heart disease.
PROCEDURES
Five trained investigators measured 4 aspects of the mitral valve and the fourth thoracic vertebrae (T4) length using multiplanar reformatting tools. Ten randomly chosen animals were measured by all investigators to determine interobserver reliability.
RESULTS
There were 233 CT scans eligible for inclusion. Dogs weighed 2 to 96 kg (mean, 28.1 kg), with a variety of breeds represented. Golden Retrievers (n = 28) and Labrador Retrievers (n = 37) were overrepresented. The intraclass correlations were all greater than 0.9, showing excellent agreement between observers. The means and SDs of each measurement were as follows: trigone-to-trigone distance, 17.2 ± 4.7 mm; the remaining circumference, 79.0 ± 17.5 mm; commissure-to-commissure distance, 30.8 ± 6.5 mm; septal leaflet-to-lateral leaflet distance, 26.3 ± 6.0 mm; T4 length, 16.9 ± 3.1 mm; and the total circumference normalized by T4, 5.7 ± 0.7 mm.
CLINICAL RELEVANCE
This study provides information that may help in the development of future treatment for mitral valve dysfunction and subsequent annular enlargement.
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Affiliation(s)
- Wanda J. Gordon-Evans
- Veterinary Clinical Sciences Department, Veterinary Medical Center, University of Minnesota, St. Paul, MN
| | - K. Helena Montin
- Veterinary Clinical Sciences Department, Veterinary Medical Center, University of Minnesota, St. Paul, MN
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Aoki T, Miyamoto T, Fukamachi N, Niimi S, Jingya Y, Wakao Y. Combination of the Modified Loop Technique and De Vega Annuloplasty in Dogs with Mitral Regurgitation. Animals (Basel) 2022; 12:ani12131653. [PMID: 35804552 PMCID: PMC9264785 DOI: 10.3390/ani12131653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/07/2022] [Accepted: 06/24/2022] [Indexed: 11/21/2022] Open
Abstract
Background: Detailed surgical techniques for treating canine mitral regurgitation have not been previously reported. Method: This case series included six consecutive client-owned dogs with mitral regurgitation. All dogs underwent a combined protocol, including the modified loop technique and De Vega annuloplasty (MODEL surgery), in 2021. Artificial loops covering 80% of the length of the strut chordae tendineae were used for chordal replacement. Mitral annuloplasty was subjectively performed, targeting the circumference of the septal leaflet. Results: The breeds were Chihuahua-mixed breed, Spitz, Pomeranian, Cavalier King Charles Spaniel, and Chihuahua, with average ages and weights of 11.4 ± 2.3 years and 5.49 ± 2.98 kg, respectively. The aortic cross-clamp, pumping, and surgery times were 64.0 ± 7.5 min, 168.5 ± 39.1 min, and 321.0 ± 53.1 min, respectively. After MODEL surgery, left atrial-to-aortic ratios significantly decreased from 2.20 ± 0.18 to 1.26 ± 0.22 (p < 0.01), and left ventricular end-diastolic internal diameter normalized to body weight significantly decreased from 2.03 ± 0.26 to 1.48 ± 0.20 (p < 0.01). In all cases, the clinical signs disappeared or improved significantly. Conclusions: MODEL surgery increased mitral valve coaptation, normalized heart sizes, and significantly improved clinical signs in dogs with mitral regurgitation.
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Affiliation(s)
- Takuma Aoki
- Laboratory of Small Animal Surgery, Department of Veterinary Medicine, School of Veterinary Medicine, Azabu University, Sagamihara 252-5201, Kanagawa, Japan; (S.N.); (Y.J.); (Y.W.)
- Department of Cardiology and Respieratory Disease, Azabu University Veterinary Teaching Hospital, Azabu University, Sagamihara 252-5201, Kanagawa, Japan
- Correspondence: ; Tel.: +81-42-754-7111
| | | | | | - Seiya Niimi
- Laboratory of Small Animal Surgery, Department of Veterinary Medicine, School of Veterinary Medicine, Azabu University, Sagamihara 252-5201, Kanagawa, Japan; (S.N.); (Y.J.); (Y.W.)
- Department of Cardiology and Respieratory Disease, Azabu University Veterinary Teaching Hospital, Azabu University, Sagamihara 252-5201, Kanagawa, Japan
| | - Yao Jingya
- Laboratory of Small Animal Surgery, Department of Veterinary Medicine, School of Veterinary Medicine, Azabu University, Sagamihara 252-5201, Kanagawa, Japan; (S.N.); (Y.J.); (Y.W.)
- Department of Cardiology and Respieratory Disease, Azabu University Veterinary Teaching Hospital, Azabu University, Sagamihara 252-5201, Kanagawa, Japan
| | - Yoshito Wakao
- Laboratory of Small Animal Surgery, Department of Veterinary Medicine, School of Veterinary Medicine, Azabu University, Sagamihara 252-5201, Kanagawa, Japan; (S.N.); (Y.J.); (Y.W.)
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Clinical use of tissue plasminogen activator for systemic thrombolysis in dogs and cats. J Vet Cardiol 2022; 41:154-164. [DOI: 10.1016/j.jvc.2022.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 02/22/2022] [Accepted: 02/25/2022] [Indexed: 11/17/2022]
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Sasaki K, Ma D, Mandour AS, Ozai Y, Yoshida T, Matsuura K, Takeuchi A, Cheng CJ, El-Husseiny HM, Hendawy H, Shimada K, Hamabe L, Uemura A, Tanaka R. Evaluation of Changes in the Cardiac Function before and after Transcatheter Edge-to-Edge Mitral Valve Repair in Healthy Dogs: Conventional and Novel Echocardiography. Animals (Basel) 2021; 12:56. [PMID: 35011161 PMCID: PMC8749712 DOI: 10.3390/ani12010056] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/08/2021] [Accepted: 12/14/2021] [Indexed: 11/25/2022] Open
Abstract
Mitral valve regurgitation is a common canine heart disease. Transcatheter Edge-to-Edge Repair (TEER) is a transcatheter, edge-to-edge mitral repair device that uses a hybrid approach. No detailed information has been published on the hemodynamic effect of TEER on cardiac function. The aim of this report is to provide a longitudinal observation of the cardiac functional changes observed after TEER implantation in normal dogs using traditional, two-dimensional speckle tracking, and color M-mode echocardiographic methods. In the current report, TEER was implanted into two healthy dogs under general anesthesia. An echocardiographic examination was performed at baseline and weekly postoperative follow-ups were conducted until the fourth week. Successful TEER implantation was achieved with a short operation time (98 and 63 min) in the two dogs. Functional mitral valve regurgitation, elevated E/e' ratio, elevated radial strain, and stable intraventricular pressure gradients (IVPG) were observed after the operation in the dogs. Mild non progressive mitral valve stenosis was observed in both dogs. TEER is a minimally invasive method for mitral valve surgery that necessitates more clinical trials. With longitudinal observation of heart function using novel approaches, better outcomes will be expected.
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Affiliation(s)
- Kenta Sasaki
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu-shi 183-8509, Tokyo, Japan; (K.S.); (D.M.); (Y.O.); (T.Y.); (K.M.); (A.T.); (C.-J.C.); (H.M.E.-H.); (H.H.); (K.S.); (L.H.)
| | - Danfu Ma
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu-shi 183-8509, Tokyo, Japan; (K.S.); (D.M.); (Y.O.); (T.Y.); (K.M.); (A.T.); (C.-J.C.); (H.M.E.-H.); (H.H.); (K.S.); (L.H.)
- College of Veterinary Medicine, Nanjing Agricultural University, No. 1 Wei-Gang, Xuanwu District, Nanjing 210095, China
| | - Ahmed S. Mandour
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu-shi 183-8509, Tokyo, Japan; (K.S.); (D.M.); (Y.O.); (T.Y.); (K.M.); (A.T.); (C.-J.C.); (H.M.E.-H.); (H.H.); (K.S.); (L.H.)
- Department of Animal Medicine (Internal Medicine), Faculty of Veterinary Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Yusuke Ozai
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu-shi 183-8509, Tokyo, Japan; (K.S.); (D.M.); (Y.O.); (T.Y.); (K.M.); (A.T.); (C.-J.C.); (H.M.E.-H.); (H.H.); (K.S.); (L.H.)
| | - Tomohiko Yoshida
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu-shi 183-8509, Tokyo, Japan; (K.S.); (D.M.); (Y.O.); (T.Y.); (K.M.); (A.T.); (C.-J.C.); (H.M.E.-H.); (H.H.); (K.S.); (L.H.)
| | - Katsuhiro Matsuura
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu-shi 183-8509, Tokyo, Japan; (K.S.); (D.M.); (Y.O.); (T.Y.); (K.M.); (A.T.); (C.-J.C.); (H.M.E.-H.); (H.H.); (K.S.); (L.H.)
| | - Aki Takeuchi
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu-shi 183-8509, Tokyo, Japan; (K.S.); (D.M.); (Y.O.); (T.Y.); (K.M.); (A.T.); (C.-J.C.); (H.M.E.-H.); (H.H.); (K.S.); (L.H.)
| | - Chieh-Jen Cheng
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu-shi 183-8509, Tokyo, Japan; (K.S.); (D.M.); (Y.O.); (T.Y.); (K.M.); (A.T.); (C.-J.C.); (H.M.E.-H.); (H.H.); (K.S.); (L.H.)
| | - Hussein M. El-Husseiny
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu-shi 183-8509, Tokyo, Japan; (K.S.); (D.M.); (Y.O.); (T.Y.); (K.M.); (A.T.); (C.-J.C.); (H.M.E.-H.); (H.H.); (K.S.); (L.H.)
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Benha University, Moshtohor, Toukh, Elqaliobiya 13736, Egypt
| | - Hanan Hendawy
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu-shi 183-8509, Tokyo, Japan; (K.S.); (D.M.); (Y.O.); (T.Y.); (K.M.); (A.T.); (C.-J.C.); (H.M.E.-H.); (H.H.); (K.S.); (L.H.)
- Department of Veterinary Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Kazumi Shimada
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu-shi 183-8509, Tokyo, Japan; (K.S.); (D.M.); (Y.O.); (T.Y.); (K.M.); (A.T.); (C.-J.C.); (H.M.E.-H.); (H.H.); (K.S.); (L.H.)
| | - Lina Hamabe
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu-shi 183-8509, Tokyo, Japan; (K.S.); (D.M.); (Y.O.); (T.Y.); (K.M.); (A.T.); (C.-J.C.); (H.M.E.-H.); (H.H.); (K.S.); (L.H.)
| | - Akiko Uemura
- Department of Veterinary Surgery, Division of Veterinary Research, Obihiro University of Agriculture and Veterinary Medicine, Obihiro 080-8555, Hokkaido, Japan;
| | - Ryou Tanaka
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu-shi 183-8509, Tokyo, Japan; (K.S.); (D.M.); (Y.O.); (T.Y.); (K.M.); (A.T.); (C.-J.C.); (H.M.E.-H.); (H.H.); (K.S.); (L.H.)
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Kanemoto I, Mihara K, Sato K. Open-heart techniques and mitral valve plasty for mitral regurgitation in toy- and small-breed dogs: A review. Open Vet J 2021; 11:14-26. [PMID: 33898279 PMCID: PMC8057224 DOI: 10.4314/ovj.v11i1.4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/18/2020] [Indexed: 11/17/2022] Open
Abstract
In human medicine, in the past, open-heart techniques for low-bodyweight children and newborn babies with congenital heart disease were more difficult than high-bodyweight adults. In toy- and small-breed dogs with mitral regurgitation (MR), an acquired heart disease, these techniques are more difficult to perform than for congenital heart diseases in young medium-sized or large dogs because of old age and low body weight. Therefore, improved open-heart techniques and mitral valve surgery for severe MR in older toy- and small-breed dogs are essential. Through our surface-cooling hypothermia (sHT) studies, we designed a new, improved open-heart method, namely, “the low-flow cardiopulmonary bypass (CPB) combined with deep sHT in toy- and small-breed dogs (Japan method)”; sHT was later replaced by blood-cooling hypothermia (bHT). At the same time, we devised a new, improved mitral valve plasty (MVP) applicable to severe MR, instead of mitral valve replacement, in toy- and small-breed dogs. This MVP technique was combined with artificial chordal reconstruction, semi-circular suture annuloplasty (AP), and direct scallop-suture valvuloplasty. These MVP techniques are simple, durable, and lead to good long-term quality of life in toy- and small-breed dogs. This review highlights the benefits of our improved CPB and MVP techniques (Japan method) for severe MR in toy-and small-breed dogs, which have led to a high success rate for MVP in severe clinical MR cases in Japan. It may further contribute to the development of more robust techniques for MR in toy- and small-breed dogs. This also represents the first comprehensive review of the history of open-heart surgery, CPB techniques, and MVP methods for MR in toy- and small-breed dogs.
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Affiliation(s)
- Isamu Kanemoto
- Cardiac Surgery Team, Chayagasaka Animal Hospital, Nagoya, Japan.,School of Medicine, Institute for Laboratory Animal Research, Nagoya University, Nagoya, Japan
| | - Kippei Mihara
- Cardiac Surgery Team, Chayagasaka Animal Hospital, Nagoya, Japan.,Joint Graduate School of Veterinary Medicine, Kagoshima University, Kagoshima, Japan
| | - Keiichi Sato
- Cardiac Surgery Team, Chayagasaka Animal Hospital, Nagoya, Japan.,School of Medicine, Nagoya University, Nagoya, Japan
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8
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Liu B, Leach SB, Pan W, Zheng F, Jia L, Zhou X, Li J. Preliminary Outcome of a Novel Edge-to-Edge Closure Device to Manage Mitral Regurgitation in Dogs. Front Vet Sci 2020; 7:597879. [PMID: 33392290 PMCID: PMC7773927 DOI: 10.3389/fvets.2020.597879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 12/02/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Veterinary management of mitral valve regurgitation due to mxyomatous valve disease in dogs is limited to medical treatments, which only postpones the onset of congestive heart failure or alleviates clinical symptoms. Most surgical procedures to manage this condition in humans require cardiopulmonary bypass and have a high risk of complications. Animals: Eight dogs with naturally occurring mitral valve regurgitation. Methods: Prospective observational study. All dogs were treated with a novel edge-to-edge transcatheter device named ValveClamp. The total surgical procedural time and total catheterization time were recorded. Echocardiographic variables measured pre- and post-procedure were compared using Wilcoxin-signed rank test with a P < 0.05 considered significant. Data were expressed as median and interquartile range and absolute numbers and percentages. Results: The procedural success rate was 100% and all the dogs survived without complications. The median (interquartile range) total surgical procedural time was 86.5 (76–96.2) minutes and catheterization time was 23.5 (22–33.8) minutes. Echocardiography revealed a significant reduction in mitral regurgitation severity in all dogs following the procedure based on both a reduced mitral regurgitant maximum jet area (P = 0.012) and a reduced mitral regurgitant maximum jet area to left atrial area (P = 0.018). Conclusion: The ValveClamp device is effective at reducing the severity of mitral regurgitation in dogs with naturally occurring myxomatous valve disease.
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Affiliation(s)
- Bo Liu
- College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Stacey B Leach
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, United States
| | - Wenzhi Pan
- Department of Cardiology, Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Fangyu Zheng
- College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Liujun Jia
- Beijing Key Laboratory of Pre-Clinic Research and Evaluation for Cardiovascular Implant Materials, Fuwai Hospital National Cardiovascular Centre, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xueying Zhou
- College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Jing Li
- College of Veterinary Medicine, China Agricultural University, Beijing, China
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9
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Sharp CR, deLaforcade AM, Koenigshof AM, Lynch AM, Thomason JM. Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE): Domain 4-Refining and monitoring antithrombotic therapies. J Vet Emerg Crit Care (San Antonio) 2019; 29:75-87. [PMID: 30654420 DOI: 10.1111/vec.12794] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 12/08/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To systematically review the evidence for therapeutic monitoring of antithrombotic drugs in small animals, develop guidelines regarding antithrombotic monitoring, and identify knowledge gaps in the field. DESIGN First, a standardized, systematic literature review was conducted to address predefined PICO (Population/Patient, Intervention, Control, Outcome) questions, with categorization of relevant articles according to level of evidence and quality. Preliminary guidelines were developed by PICO worksheet authors and the domain chair. Thereafter, a Delphi-style survey was used to develop consensus on guidelines regarding therapeutic monitoring of antithrombotics in dogs and cats. SETTING Academic and referral veterinary medical centers. RESULTS PICO questions regarding the utility of therapeutic monitoring were developed for 6 different antithrombotic drugs or drug classes, including aspirin, clopidogrel, warfarin, unfractionated heparin, the low molecular weight heparins, and rivaroxaban, The majority of the literature pertaining to therapeutic monitoring of antithrombotic drugs was either performed in experimental animal models of disease or involved studies of drug pharmacokinetics and pharmacodynamics in healthy laboratory animals. There was a paucity of high level of evidence studies directly addressing the PICO questions, which limited the strength of recommendations that could be provided. The final guidelines recommend that therapeutic monitoring should be performed when using warfarin or unfractionated heparin in dogs and cats at risk of thrombosis. There is insufficient evidence to make strong recommendations for therapeutic monitoring of aspirin or low molecular weight heparin in dogs and cats at this time. CONCLUSIONS As in other CURATIVE domains, significant knowledge gaps were highlighted, indicating the need for substantial additional research in this field. Ongoing investigation of the role of therapeutic monitoring of antithrombotic therapies will undoubtedly facilitate improved outcomes for dogs and cats at risk of thrombosis.
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Affiliation(s)
- Claire R Sharp
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, WA, Australia
| | - Armelle M deLaforcade
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA
| | - Amy M Koenigshof
- College of Veterinary Medicine, Michigan State University, East Lansing, MI
| | - Alex M Lynch
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - John M Thomason
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS
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10
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Goggs R, Blais MC, Brainard BM, Chan DL, deLaforcade AM, Rozanski E, Sharp CR. American College of Veterinary Emergency and Critical Care (ACVECC) Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE) guidelines: Small animal. J Vet Emerg Crit Care (San Antonio) 2019; 29:12-36. [PMID: 30654421 DOI: 10.1111/vec.12801] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 12/12/2018] [Accepted: 12/07/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To systematically review available evidence and establish guidelines related to the risk of developing thrombosis and the management of small animals with antithrombotics. DESIGN Standardized, systematic evaluation of the literature (identified by searching Medline via PubMed and CAB abstracts) was carried out in 5 domains (Defining populations at risk; Defining rational therapeutic use; Defining evidence-based protocols; Refining and monitoring antithrombotic therapies; and Discontinuing antithrombotic therapies). Evidence evaluation was carried out using Population, Intervention, Comparison, Outcome generated within each domain questions to address specific aims. This was followed by categorization of relevant articles according to level of evidence and quality (Good, Fair, or Poor). Synthesis of these data led to the development of a series of statements. Consensus on the final guidelines was achieved via Delphi-style surveys. Draft recommendations were presented at 2 international veterinary conferences and made available for community assessment, review, and comment prior to final revisions and publication. SETTINGS Academic and referral veterinary medical centers. RESULTS Over 500 studies were reviewed in detail. Worksheets from all 5 domains generated 59 statements with 83 guideline recommendations that were refined during 3 rounds of Delphi surveys. A high degree of consensus was reached across all guideline recommendations. CONCLUSIONS Overall, systematic evidence evaluations yielded more than 80 recommendations for the treatment of small animals with or at risk of developing thrombosis. Numerous significant knowledge gaps were highlighted by the evidence reviews undertaken, indicating the need for substantial additional research in this field.
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Affiliation(s)
- Robert Goggs
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY
| | - Marie-Claude Blais
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, GA
| | - Daniel L Chan
- Department Clinical Science and Services, The Royal Veterinary College, London, United Kingdom
| | - Armelle M deLaforcade
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - Elizabeth Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - Claire R Sharp
- School of Veterinary and Life Sciences, College of Veterinary Medicine, Murdoch University, Murdoch, WA, Australia
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Blais MC, Bianco D, Goggs R, Lynch AM, Palmer L, Ralph A, Sharp CR. Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE): Domain 3-Defining antithrombotic protocols. J Vet Emerg Crit Care (San Antonio) 2019; 29:60-74. [PMID: 30654416 DOI: 10.1111/vec.12795] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 12/10/2018] [Accepted: 12/08/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To systematically examine the evidence for use of a specific protocol (dose, frequency, route) of selected antithrombotic drugs, in comparisons to no therapy or to other antithrombotic therapies, to reduce the risk of complications or improve outcomes in dogs and cats at risk for thrombosis. DESIGN Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence (LOE) and quality (Good, Fair, or Poor), and development of consensus on conclusions via a Delphi-style survey for application of the concepts to clinical practice. SETTINGS Academic and referral veterinary medical centers. RESULTS Databases searched included Medline via PubMed and CAB abstracts. Eight different antithrombotic drugs were investigated using a standardized Patient, Intervention, Comparison, Outcome (PICO) question format both for dogs and cats, including aspirin, clopidogrel, warfarin, unfractionated heparin (UFH), dalteparin, enoxaparin, fondaparinux, and rivaroxaban, generating a total of 16 worksheets. Most studies identified were experimental controlled laboratory studies in companion animals (LOE 3) with only four randomized controlled clinical trials in companion animals (LOE 1). CONCLUSIONS Overall, evidence-based recommendations concerning specific protocols could not be formulated for most antithrombotic drugs evaluated, either because of the wide range of dosage reported (eg, aspirin in dogs) or the lack of evidence in the current literature. However, clopidogrel administration in dogs and cats at risk of arterial thrombosis, notably in cats at risk of cardiogenic thromboembolism, is supported by the literature, and specific protocols were recommended. Comparably, aspirin should not be used as a sole antithrombotic in cats with cardiomyopathy. Using the available safety profile information contained in the literature, the panel reached consensus on suggested dosage schemes for most antithrombotics. Significant knowledge gaps were highlighted, which will hopefully drive novel research.
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Affiliation(s)
- Marie-Claude Blais
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, St-Hyacinthe, Quebec, Canada
| | - Domenico Bianco
- Internal Medicine Department, Metropolitan Animal Specialty Hospital, Los Angeles, CA
| | - Robert Goggs
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY
| | - Alex M Lynch
- Department of Clinical Sciences, North Carolina State University, Raleigh, NC
| | - Lee Palmer
- Lieutenant Colonel, US Army Reserve, Veterinary Corps, Chair K9 Tactical Emergency Casualty Care Working Group, New Orleans, LA
| | | | - Claire R Sharp
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Australia
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12
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Uemura A, Fukayama T, Tanaka T, Tanaka R. Utility of Lung Ultrasonography for Detection of Pleural Adhesions in Dogs. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:1193-1198. [PMID: 29090479 DOI: 10.1002/jum.14468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 08/02/2017] [Accepted: 08/05/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To assess lung respiratory movement ("lung sliding") in dogs using B-mode ultrasonography (US) and to develop a method that assesses adhesions between the parietal pleura and the lung. METHODS Seventeen male beagles were anesthetized, and respiratory management was performed with intermittent positive pressure ventilation. Lung-sliding assessments and adhesion examinations were performed with lung US under general anesthesia before and 2 weeks after thoracotomy. Lung sliding was scored on a 4-level scale based on the percentage of the area that showed lung sliding (3, an area of roughly ≥80% of the intercostal space; 2, about 50% of the area of the intercostal space; 1, a small area of the intercostal space; or 0, movement absent); scores of 0, 1, and 2 indicated adhesions, whereas a score of 3 indicated no adhesions. The animals were then euthanized, and necropsy was performed to examine pleural adhesions. RESULTS Lung US and necropsy findings were compared. The median lung-sliding score for the 12 sites with pleural adhesions on necropsy was 1.5, whereas it was 3.0 for the 532 sites without pleural adhesions. The lung-sliding score was significantly lower in the group with adhesions (P < .0001). Adhesion sites detected on necropsy were in accordance with the sites that had decreased lung-sliding scores. Lung US could detect pleural adhesions with sensitivity of 100.0% and specificity of 87.8%. CONCLUSIONS Examination of lung sliding by thoracic US has high diagnostic value for detecting canine pleural adhesions and is useful in predicting adhesion sites before thoracic surgery in healthy dogs.
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Affiliation(s)
- Akiko Uemura
- Tokyo University of Agriculture and Technology Animal Medical Center, Tokyo, Japan
| | | | - Takashi Tanaka
- Tokyo University of Agriculture and Technology Animal Medical Center, Tokyo, Japan
| | - Ryou Tanaka
- Tokyo University of Agriculture and Technology Animal Medical Center, Tokyo, Japan
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13
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Bristow P, Sargent J, Luis Fuentes V, Brockman D. Surgical treatment of pulmonic stenosis in dogs under cardiopulmonary bypass: outcome in nine dogs. J Small Anim Pract 2017; 59:38-44. [DOI: 10.1111/jsap.12793] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 10/03/2017] [Accepted: 10/06/2017] [Indexed: 11/28/2022]
Affiliation(s)
- P. Bristow
- Department of Veterinary Clinical Sciences; Royal Veterinary College; Hatfield Herts AL9 7TA UK
| | - J. Sargent
- Department of Veterinary Clinical Sciences; Royal Veterinary College; Hatfield Herts AL9 7TA UK
| | - V. Luis Fuentes
- Department of Veterinary Clinical Sciences; Royal Veterinary College; Hatfield Herts AL9 7TA UK
| | - D. Brockman
- Department of Veterinary Clinical Sciences; Royal Veterinary College; Hatfield Herts AL9 7TA UK
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Yokoyama S, Kanemoto I, Mihara K, Ando T, Kawase K, Sahashi Y, Iguchi K. Treatment of severe mitral regurgitation caused by lesions in both leaflets using multiple mitral valve plasty techniques in a small dog. Open Vet J 2017; 7:328-331. [PMID: 29201662 PMCID: PMC5708598 DOI: 10.4314/ovj.v7i4.7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Accepted: 11/02/2017] [Indexed: 11/23/2022] Open
Abstract
Mitral valve plasty (MVP) is preferred over mitral valve replacement (MVR) for mitral
regurgitation in humans because of its favorable effect on quality of life. In small
dogs, it is difficult to repair multiple lesions in both leaflets using MVP. Herein,
we report a case of severe mitral regurgitation caused by multiple severe lesions in
the posterior leaflet (PL) in a mixed Chihuahua. Initially, we had planned MVR with
an artificial valve. However, MVP combined with artificial chordal reconstruction of
both leaflets, semicircular suture annuloplasty, and valvuloplasty using a newly
devised direct scallop suture for the PL was attempted in this dog. The dog recovered
well and showed no adverse cardiac signs, surviving two major operations. The dog
died 4 years and 10 months after the MVP due to non-cardiovascular disease. Our
additional technique of using a direct scallop suture seemed useful for PL repair
involving multiple scallops in a small dog.
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Affiliation(s)
- Satoko Yokoyama
- Chayagasaka Animal Hospital, 1-1-5 Shinnishi, Chikusa, Nagoya, Aichi, 464-0003 Japan.,Miyashita Animal Hospital, 5-8-29 Kegoya, Kure, Hiroshima, 737-0012 Japan
| | - Isamu Kanemoto
- Chayagasaka Animal Hospital, 1-1-5 Shinnishi, Chikusa, Nagoya, Aichi, 464-0003 Japan
| | - Kippei Mihara
- Chayagasaka Animal Hospital, 1-1-5 Shinnishi, Chikusa, Nagoya, Aichi, 464-0003 Japan
| | - Takanori Ando
- Chayagasaka Animal Hospital, 1-1-5 Shinnishi, Chikusa, Nagoya, Aichi, 464-0003 Japan.,Heart-Will Animal Hospital, 1-2-14 Okidai, Tobata, Kita-Kyushu, Fukuoka, 804-0064 Japan
| | - Koudai Kawase
- Chayagasaka Animal Hospital, 1-1-5 Shinnishi, Chikusa, Nagoya, Aichi, 464-0003 Japan.,Sapporo Night Animal Hospital Emergency & Critical Care, 7-5-6 Minami-2 Zyou-nishi, Chuo, Sapporo, Hokkaido, 060-0062 Japan
| | - Yasuaki Sahashi
- Chayagasaka Animal Hospital, 1-1-5 Shinnishi, Chikusa, Nagoya, Aichi, 464-0003 Japan.,Garcia Animal Hospital, 2-1-56 Tatumi, Koutou-ku, Tokyo, 135-0053 Japan
| | - Kazuhito Iguchi
- Chayagasaka Animal Hospital, 1-1-5 Shinnishi, Chikusa, Nagoya, Aichi, 464-0003 Japan.,Momijiyama Douri Pet Clinic, 5-2-9 Nakano, Nakano-ku, Tokyo, 164-0001 Japan
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15
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Menciotti G, Borgarelli M. Review of Diagnostic and Therapeutic Approach to Canine Myxomatous Mitral Valve Disease. Vet Sci 2017; 4:vetsci4040047. [PMID: 29056705 PMCID: PMC5753627 DOI: 10.3390/vetsci4040047] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 09/09/2017] [Accepted: 09/20/2017] [Indexed: 01/11/2023] Open
Abstract
The most common heart disease that affects dogs is myxomatous mitral valve disease. In this article, we review the current diagnostic and therapeutic approaches to this disease, and we also present some of the latest technological advancements in this field.
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Affiliation(s)
- Giulio Menciotti
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, 205 Duck Pond Dr., Blacksburg, VA 24061, USA.
| | - Michele Borgarelli
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, 205 Duck Pond Dr., Blacksburg, VA 24061, USA.
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Hogan DF. Feline Cardiogenic Arterial Thromboembolism: Prevention and Therapy. Vet Clin North Am Small Anim Pract 2017; 47:1065-1082. [PMID: 28662872 DOI: 10.1016/j.cvsm.2017.05.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Feline cardiogenic arterial thromboembolism (CATE) is a devastating disease whereby 33% of cats survive their initial event, although approximately 50% of mortality is from euthanasia. Short-term management focuses on inducing a hypocoagulable state, improving blood flow, and providing supportive care. Ideally, all cats should be given 72 hours of treatment to determine the acute clinical course. Preventive protocols include antiplatelet and/or anticoagulant drugs, with the only prospective clinical trial demonstrating that clopidogrel is superior to aspirin with a lower CATE recurrence rate and longer time to recurrent CATE. Newer anticoagulant drugs hold great promise in the future of managing this disease.
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Affiliation(s)
- Daniel F Hogan
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, Lynn Hall, 625 Harrison Street, West Lafayette, IN 47907-2026, USA.
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Borgarelli M, Lanz O, Pavlisko N, Abbott JA, Menciotti G, Aherne M, Lahmers SM, Lahmers KK, Gammie JS. Mitral valve repair in dogs using an ePTFE chordal implantation device: a pilot study. J Vet Cardiol 2017; 19:256-267. [PMID: 28576476 DOI: 10.1016/j.jvc.2017.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 02/07/2017] [Accepted: 03/28/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Mitral valve (MV) regurgitation due to degenerative MV disease is the leading cause of cardiac death in dogs. We carried out preliminary experiments to determine the feasibility and short-term effects of beating-heart MV repair using an expanded polytetrafluorethylene (ePTFE) chordal implantation device (Harpoon TSD-5) in dogs. ANIMALS This study involved six healthy purpose-bred Beagles (weight range 8.9-11.4 kg). MATERIAL AND METHODS Following a mini-thoracotomy performed under general anesthesia, the TSD-5 was used to place 1 or 2 artificial ePTFE cords on the anterior MV leaflet or the posterior MV leaflet via a left-ventricular transapical approach. The procedure was guided and monitored by transesophageal echocardiography. Postoperative antithrombotic treatment consisted of clopidogrel or a combination of clopidogrel and apixaban. Dogs were serially evaluated by transthoracic echocardiography at day 1, 7, 14, 21, and 30. The hearts were then examined for evaluation of tissues reactions and to detect signs of endothelialization. RESULTS One or two chords were successfully implanted in five dogs. Four dogs completed the 30 days follow-up. One dog died intra-operatively because of aortic perforation. One dog died early post-operatively from a hemorrhagic pleural effusion attributed to overly aggressive antithrombotic treatment. One dog developed a thrombus surrounding both the knot and the synthetic cord. Postmortem exam confirmed secure placement of ePTFE knots in the mitral leaflets in all dogs and the presence of endothelialization of the knots and chords. CONCLUSIONS These preliminary results demonstrate the feasibility of artificial chordal placement using an ePTFE cordal implantation device in dogs.
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Affiliation(s)
- M Borgarelli
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Phase II, Duck Pond Dr., VA 24061, USA.
| | - O Lanz
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Phase II, Duck Pond Dr., VA 24061, USA
| | - N Pavlisko
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Phase II, Duck Pond Dr., VA 24061, USA
| | - J A Abbott
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Phase II, Duck Pond Dr., VA 24061, USA
| | - G Menciotti
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Phase II, Duck Pond Dr., VA 24061, USA
| | - M Aherne
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Phase II, Duck Pond Dr., VA 24061, USA
| | - S M Lahmers
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Phase II, Duck Pond Dr., VA 24061, USA
| | - K K Lahmers
- Department of Biomedical Sciences & Pathobiology, Virginia-Maryland College of Veterinary Medicine, Blacksburg, 205 Duck Pond Dr., VA 24061, USA
| | - J S Gammie
- Division of Cardiac Surgery, University of Maryland School of Medicine, 110 S. Paca St., MD 21201, USA
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Bristow P, Sargent J, Luis Fuentes V, Brockman D. Outcome of bioprosthetic valve replacement in dogs with tricuspid valve dysplasia. J Small Anim Pract 2017; 58:205-210. [DOI: 10.1111/jsap.12630] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 10/17/2016] [Accepted: 10/25/2016] [Indexed: 10/20/2022]
Affiliation(s)
- P. Bristow
- Department of Veterinary Clinical Sciences; Royal Veterinary College, Hatfield, Herts AL9 7TA; UK
| | - J. Sargent
- Department of Veterinary Clinical Sciences; Royal Veterinary College, Hatfield, Herts AL9 7TA; UK
| | - V. Luis Fuentes
- Department of Veterinary Clinical Sciences; Royal Veterinary College, Hatfield, Herts AL9 7TA; UK
| | - D. Brockman
- Department of Veterinary Clinical Sciences; Royal Veterinary College, Hatfield, Herts AL9 7TA; UK
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19
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Cardiogenic embolism in the cat. J Vet Cardiol 2015; 17 Suppl 1:S202-14. [DOI: 10.1016/j.jvc.2015.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 10/21/2015] [Accepted: 10/22/2015] [Indexed: 01/17/2023]
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Kelmer E, Segev G, Codner C, Bruchim Y, Klainbart S, Aroch I. Assessment of a portable prothrombin time analyzer (CoaguChek-XS) in dogs. J Vet Emerg Crit Care (San Antonio) 2014; 24:455-60. [PMID: 25039332 DOI: 10.1111/vec.12200] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 05/25/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess the performance of a portable prothrombin time (PT) analyzer (CoaguChek-XS) in dogs. ANIMALS Ninety-seven dogs composed of 20 healthy dogs, 45 ill dogs, and 32 ill dogs with altered coagulation. PROCEDURES Samples were concurrently obtained and PT was measured using the CoaguChek-XS and an automated coagulation analyzer. Agreement between methods was assessed using Spearman's correlation and Bland-Altman analysis. RESULTS The reference interval for PT using the CoaguChek-XS was 9.6-11.5 s. The CoaguChek-XS was easy to use, required a small volume of whole blood, and gave results within 1 min. The mean difference in PT between the 2 methods was 2.58 s (SD 3.10), and 94% of the samples fell within limits of agreement. The correlation was moderate, but significant (r = 0.35, P < 0.001). Sensitivity and specificity of the CoaguCheck-XS PT compared to analyzer PT were 92% and 56%, respectively, and increased to 95% and 77% on intent to treat basis. The coefficient of variance was 0.72%. The CoaguChek-XS identified all 8 dogs with anticoagulant rodenticide intoxication, although a discrepancy was noted from the analyzer results. In anemic dogs (PCV≤25%), the CoaguChek-XS did not display accurate results. CONCLUSIONS The CoaguChek-XS is a simple, user-friendly, highly precise PT analyzer. Results had moderate correlation and good agreement with a standard method. It can be used reliably for screening dogs when the PT is normal. However, when the CoaguChek-XS PT is prolonged or when the PCV is ≤25%, results should be confirmed using a standard method.
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Affiliation(s)
- Efrat Kelmer
- Department of Small Animal Emergency and Critical Care, the Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Rehovot, Israel
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Knupp SNR, Vale DF, Monteiro GS, Luz MJ, Sheffer JP, Oliveira AL. Aspectos hemodinâmicos da circulação extracorpórea em cães. CIÊNCIA ANIMAL BRASILEIRA 2014. [DOI: 10.1590/1809-6891v15i218110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A circulação extracorpórea (CEC) promove alterações graves no organismo do paciente que necessita ser submetido a esse procedimento, que pode, no entanto, ser contornadas ou minimizadas com manobras específicas para cada situação. Apesar de ser uma técnica já estabelecida na medicina humana, ainda existem avanços a serem alcançados. Objetivou-se com este trabalho descrever a técnica de circulação extracorpórea e informar seus efeitos hemodinâmicos quando aplicada em cães. Utilizaram-se quatro cães hígidos, sem raça definida. Os animais foram submetidos à anestesia e monitoramentos e coletas sanguíneas foram realizadas (T0). Em seguida, os animais foram submetidos à esternotomia mediana, canulação da artéria aorta e veias cava cranial e caudal e mantidos por um período de 30 minutos em CEC (T1), foram, depois, desconectados da máquina de CEC, permanecendo por 30 minutos em processo de reperfusão (T2), seguidos de uma hora de reperfusão (T3), sendo, então, eutanasiados. Avaliaram-se os seguintes parâmetros: pressão arterial média, pressão venosa central, oxigenação (SaO2) e capnografia (ETCO2). PAM, PVC e SaO2 permaneceram dentro da normalidade durante os tempos avaliados, já a média observada do ETCO2 estava abaixo apenas em um dos animais experimentais, porém os valores mantiveram-se dentro da normalidade na maioria dos animais experimentais. Concluiu-se que a CEC é possível de ser realizada em cães, sem prejuízos hemodinâmicos graves, considerando-se os parâmetros avaliados neste experimento.
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22
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Mitral Valve Replacement with a Mechanical Valve for Severe Mitral Regurgitation in a Small Dog. Case Rep Vet Med 2014. [DOI: 10.1155/2014/892625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A seven-year-old Shih Tzu with refractory repeated pulmonary edema and syncope was presented for surgical operation. From the results of cardiovascular examinations, the dog was diagnosed as severe mitral regurgitation (ACVIM consensus class D) and mild tricuspid regurgitation. The dog first underwent surgery with mitral valve plasty; however, the results were unsatisfactory due to severe damage of the whole mitral valve. The operation was quickly changed to mitral valve replacement using a mechanical valve (19 mm). The dog survived surgery and lived for 2 years and one month after operation using long-term anticoagulant (warfarin) therapy in spite of several thrombosis-related events.
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Robinson R, Chang YM, Seymour CJ, Pelligand L. Predictors of outcome in dogs undergoing thoracic surgery (2002-2011). Vet Anaesth Analg 2013; 41:259-68. [PMID: 24330233 DOI: 10.1111/vaa.12112] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 04/26/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate mortality in a canine population undergoing thoracic surgery and identify factors which may be associated with outcome. STUDY DESIGN Retrospective cohort study. ANIMALS 286 dogs anaesthetized for thoracic surgery at the Royal Veterinary College between June 2002 - June 2011. METHODS Variables examined included: signalment; ASA status; nature of disease; presence of co-morbidities; pre-anaesthetic oxygen requirement; surgical approach; anaesthesia management [anaesthetic agents; requirement for thoracocentesis; central venous pressure measurement; duration of surgery and anaesthesia; use of colloids, blood products, inotropes or neuromuscular blocking agents (NMBA)]. Outcome was defined as either non-survival to 24 hours after surgery or (having survived to 24 hours) to discharge. Univariate and multivariable logistic regressions were performed to identify risk factors associated with non-survival. RESULTS Overall non-survival (excluding those euthanased) to discharge was 5.9%. Non-survival was 2.2% at 24 hours and 3.6% at time of discharge. Non-survival to 24 hours was associated with pre-anaesthetic oxygen requirement (odds ratio (OR) 12.2 [95% CI 1.8-84.5]) and NMBA use (OR 9.6 [95% CI 1.6-57.9]). Non-survival to discharge was associated with surgical duration, with surgeries >180 minutes having OR 16.9 [95% CI 2.0-144.0] compared to surgeries ≤90 minutes and blood product use (OR 4.6 [95% CI 1.3-14.6]). No association was found between ASA category and non-survival at 24 hours (OR 1.4 [95% CI 0.2-11.7]) or discharge (OR 4.4 [95% CI 0.6-34.3]). Significant associations were found between NMBA use and ASA category (p = 0.046), surgical duration (p = 0.002), use of colloids (p = 0.011), blood products (p = 0.001) and inotropes and/or vasopressors (p < 0.001). CONCLUSIONS AND CLINICAL RELEVANCE Variables significantly associated with non-survival from canine thoracic surgery at 24 hours include NMBA use and pre-anaesthetic oxygen requirement. Blood product use and increasing surgical duration were associated with non-survival to hospital discharge. The associations may relate to the need for such products in the most complicated cases.
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Affiliation(s)
- Rebecca Robinson
- Department of Veterinary Clinical Sciences, Royal Veterinary College, University of London, London, UK
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Aoki T, Fujii Y, Sunahara H, Takano H, Wakao Y. Modified loop technique in three dogs with mitral regurgitation. J Vet Med Sci 2013; 75:107-11. [PMID: 22971666 DOI: 10.1292/jvms.11-0486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Mitral valvuloplasty (MVP) is used in dogs with refractory mitral regurgitation (MR); however, it is difficult to tie the artificial chord, i.e., the expanded polytetrafluoroethylene suture, at the planned height of the mitral valve, because of the slippery nature of the knot. The loop technique has resolved these difficulties in humans. Premanufactured loops (length, 8.0-15.0 mm with 1.0-mm increments) were used in the new modified loop technique. In the current study, cardiac murmurs disappeared, and the MR markedly improved or completely disappeared approximately 3 months after surgery in 3 dogs. Therefore, this new technique might be effective in dogs.
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Affiliation(s)
- Takuma Aoki
- Department of Surgery, School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara, Kanagawa 252-5201, Japan.
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Pelosi A, Anderson LK, Paugh J, Robinson S, Eyster GE. Challenges of cardiopulmonary bypass-a review of the veterinary literature. Vet Surg 2012; 42:119-36. [PMID: 23164065 DOI: 10.1111/j.1532-950x.2012.01008.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cardiopulmonary bypass (CPB) has been used in veterinary medicine in experimental surgery and to address congenital and acquired diseases. We review the veterinary literature and expose common challenges of CPB in dogs and cats. Specifically, we describe the most specific elements of this technique in veterinary patients. The variety in animal size has made it difficult to standardize cannulation techniques, oxygenators, and priming volumes and solutions. The fact that one of the most common cardiovascular disorders, mitral valve disease, occurs predominantly in small dogs has limited the use of bypass in these patients because of the need for small, low prime oxygenators and pumps that have been unavailable until recently. Coagulation, hemostasis, and blood product availability have also represented important factors in the way CPB has developed over the years. The cost and the challenges in operating the bypass machine have represented substantial limitations in its broader use.
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Affiliation(s)
- Augusta Pelosi
- Small Animal Clinical Sciences, Michigan State University, East Lansing, MI 48824-1314, USA.
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Mizuno T, Mizukoshi T, Uechi M. Long-term outcome in dogs undergoing mitral valve repair with suture annuloplasty and chordae tendinae replacement. J Small Anim Pract 2012; 54:104-7. [PMID: 23146131 DOI: 10.1111/j.1748-5827.2012.01305.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Mitral valve repair under cardiopulmonary bypass was performed in three dogs with clinical signs associated with mitral regurgitation that were not controlled by medication. Mitral valve repair comprised circumferential annuloplasty and chordal replacement with expanded polytetrafluoroethylene. One dog died 2 years after surgery because of severe mitral regurgitation resulting from partial circumferential suture detachment. The others survived for over 5 years, but mild mitral valve stenosis persisted in one. The replaced chordae did not rupture in any dog. Mitral valve repair appears to be an effective treatment for mitral regurgitation in dogs. Chordal replacement with expanded polytetrafluoroethylene is a feasible technique, demonstrating long-term durability in dogs. However, mitral annuloplasty techniques need improvement.
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Affiliation(s)
- T Mizuno
- Veterinary Cardiovascular Medicine and Surgery, Laboratory of Veterinary Internal Medicine, Department of Veterinary Medicine, College of Bioresource Science, Nihon University, 1866 Fujisawa, Kanagawa, 252-0880, Japan
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Nakamura RK, Zimmerman SA, Lange AJ, Lesser MB. Isolation of methicillin-resistant Staphylococcus lugdunensis in a dog with endocarditis. J Vet Cardiol 2012; 14:531-6. [PMID: 23098628 DOI: 10.1016/j.jvc.2012.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Revised: 03/14/2012] [Accepted: 04/04/2012] [Indexed: 11/16/2022]
Abstract
A 4-year-old male castrated Borzoi dog presented on referral for evaluation of pleural effusion, ventricular arrhythmias, and suspected dilated cardiomyopathy. Echocardiogram identified several masses along the chordae tendineae, as well as a long the annulus of the mitral valve. A blood culture was positive for methicillin resistant Staphylococcus lugdunensis. The dog was also positive for Bartonella DNA on PCR testing. Aggressive antibiotic therapy was instituted. However, the dog continued to have recurrent pleural effusion and progressive azotemia. The dog was euthanized 39 days after diagnosis. Necropsy confirmed the presence of intracardiac abscesses, thrombosis and endocarditis. S. lugdunensis is a recently identified rare cause of endocarditis in humans characterized by intracardiac abscess formation, highly destructive valvular lesions preferentially affecting the mitral valve and a high mortality rate. This is the first reported case of S. lugdunensis isolation in a dog with endocarditis.
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Uechi M, Mizukoshi T, Mizuno T, Mizuno M, Harada K, Ebisawa T, Takeuchi J, Sawada T, Uchida S, Shinoda A, Kasuya A, Endo M, Nishida M, Kono S, Fujiwara M, Nakamura T. Mitral valve repair under cardiopulmonary bypass in small-breed dogs: 48 cases (2006-2009). J Am Vet Med Assoc 2012; 240:1194-201. [PMID: 22559109 DOI: 10.2460/javma.240.10.1194] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine whether mitral valve repair (MVR) under cardiopulmonary bypass would be an effective treatment for mitral regurgitation in small-breed dogs. DESIGN Retrospective case series. ANIMALS 48 small-breed dogs (body weight, 1.88 to 4.65 kg [4.11 to 10.25 lb]; age, 5 to 15 years) with mitral regurgitation that underwent surgery between August 2006 and August 2009. PROCEDURES Cardiopulmonary bypass was performed with a cardiopulmonary bypass circuit. After induction of cardiac arrest, a mitral annuloplasty was performed, and the chordae tendineae were replaced with expanded polytetrafluoroethylene chordal prostheses. After closure of the left atrium and declamping to restart the heart, the thorax was closed. RESULTS Preoperatively, cardiac murmur was grade 3 of 6 to 6 of 6, thoracic radiography showed cardiac enlargement (median vertebral heart size, 12.0 vertebrae; range, 9.5 to 14.5 vertebrae), and echocardiography showed severe mitral regurgitation and left atrial enlargement (median left atrium-to-aortic root ratio, 2.6; range, 1.7 to 4.0). 45 of 48 dogs survived to discharge. Three months after surgery, cardiac murmur grade was reduced to 0/6 to 3/6, and the heart shadow was reduced (median vertebral heart size, 11.1 vertebrae, range, 9.2 to 13.0 vertebrae) on thoracic radiographs. Echocardiography confirmed a marked reduction in mitral regurgitation and left atrium-to-aortic root ratio (median, 1.7; range, 1.0 to 3.0). CONCLUSIONS AND CLINICAL RELEVANCE We successfully performed MVR under cardiopulmonary bypass in small-breed dogs, suggesting this may be an effective surgical treatment for dogs with mitral regurgitation. Mitral valve repair with cardiopulmonary bypass can be beneficial for the treatment of mitral regurgitation in small-breed dogs.
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Affiliation(s)
- Masami Uechi
- Veterinary Cardiovascular Medicine and Surgery Unit, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Chiyoda-ku 102-8275, Tokyo, Japan.
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Richards JM, Farrar EJ, Kornreich BG, Moïse NS, Butcher JT. The mechanobiology of mitral valve function, degeneration, and repair. J Vet Cardiol 2012; 14:47-58. [PMID: 22366572 PMCID: PMC3586284 DOI: 10.1016/j.jvc.2012.01.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 12/24/2011] [Accepted: 01/17/2012] [Indexed: 12/28/2022]
Abstract
In degenerative valve disease, the highly organized mitral valve leaflet matrix stratification is progressively destroyed and replaced with proteoglycan rich, mechanically inadequate tissue. This is driven by the actions of originally quiescent valve interstitial cells that become active contractile and migratory myofibroblasts. While treatment for myxomatous mitral valve disease in humans ranges from repair to total replacement, therapies in dogs focus on treating the consequences of the resulting mitral regurgitation. The fundamental gap in our understanding is how the resident valve cells respond to altered mechanical signals to drive tissue remodeling. Despite the pathological similarities and high clinical occurrence, surprisingly little mechanistic insight has been gleaned from the dog. This review presents what is known about mitral valve mechanobiology from clinical, in vivo, and in vitro data. There are a number of experimental strategies already available to pursue this significant opportunity, but success requires the collaboration between veterinary clinicians, scientists, and engineers.
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Affiliation(s)
| | - Emily J. Farrar
- Department of Biomedical Engineering, Cornell University, Ithaca NY, USA
| | - Bruce G. Kornreich
- Department of Clinical Sciences, Section of Cardiology, College of Veterinary Medicine, Cornell University, Ithaca NY, USA
| | - N. Sydney Moïse
- Department of Clinical Sciences, Section of Cardiology, College of Veterinary Medicine, Cornell University, Ithaca NY, USA
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Uechi M. Mitral valve repair in dogs. J Vet Cardiol 2012; 14:185-92. [PMID: 22366571 DOI: 10.1016/j.jvc.2012.01.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Revised: 12/01/2011] [Accepted: 01/12/2012] [Indexed: 11/17/2022]
Abstract
Prognosis for dogs with severe mitral regurgitation is poor with medical therapy alone. Open surgical mitral valve repair consisting of circumferential mitral annuloplasty and artificial chordal replacement confers durability and improved long-term clinical outcome without a need for long-term antithrombotic therapies. This approach has been successfully used in canine patients, including small-breed dogs. Methods for mitral valve repair applicable to small dogs are described.
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Affiliation(s)
- Masami Uechi
- Veterinary Cardiovascular Medicine and Surgery, Laboratory of Veterinary Internal Medicine, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1866 Kameino, Fujisawa, Kanagawa 252-8510, Japan.
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Arai S, Griffiths LG, Mama K, Hackett TB, Monnet E, Boon JA, Carter L, Orton EC. Bioprosthesis valve replacement in dogs with congenital tricuspid valve dysplasia: Technique and outcome. J Vet Cardiol 2011; 13:91-9. [DOI: 10.1016/j.jvc.2010.12.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Revised: 12/06/2010] [Accepted: 12/09/2010] [Indexed: 11/27/2022]
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Griffiths LG. Surgery for Cardiac Disease in Small Animals: Current Techniques. Vet Clin North Am Small Anim Pract 2010; 40:605-22. [DOI: 10.1016/j.cvsm.2010.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kanemoto I, Taguchi D, Yokoyama S, Mizuno M, Suzuki H, Kanamoto T. Open heart surgery with deep hypothermia and cardiopulmonary bypass in small and toy dogs. Vet Surg 2010; 39:674-9. [PMID: 20459489 DOI: 10.1111/j.1532-950x.2010.00687.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate open heart surgery with deep surface-induced hypothermia (sHT) and low-flow cardiopulmonary bypass (CPB) in small and toy-breed dogs. STUDY DESIGN Case series. ANIMALS Small breed dogs (n=8) weighing <5.5 kg with naturally occurring cardiac disease. METHODS Deep sHT under isoflurane anesthesia and low-flow rate CPB with a small-volume prime circuit were used. Ventricular septal defect was closed directly in 2 dogs and severe mitral regurgitation was corrected with mitral valvuloplasty (MVP) in 5 dogs and mitral valve replacement in 1 dog. RESULTS All dogs survived surgery; 1 dog died 6 days and 1 died 2 months after MVP. The other 6 dogs lived (mean follow-up, 32.8 months; range, 12-65 months). Mean body weight at surgery was 3.6 kg (range, 2-5.3 kg). Mean lowest esophageal temperature was 21.4 degrees C (range, 19.8-23.8 degrees C). Mean lowest pump flow volume was 29.2 mL/kg/min (range, 9.4-57.7 mL/kg/min) during aortic cross-clamping (mean, 53.5 minutes; range, 25-79 minutes). Mean hematocrit before CPB was 38.6% (range, 33-47%) and 20.3% (range, 13-24%) during CPB with a small circuit priming volume of 225-260 mL. CONCLUSION Deep sHT with low-flow rate CPB may be used for open heart surgery in small dogs weighing <5.5 kg. CLINICAL RELEVANCE Open heart surgery for selected congenital defects and acquired defects in small and toy-breed dogs may be successfully performed using deep sHT and CPB.
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Ishikawa T, Tanaka R, Suzuki S, Saida Y, Soda A, Fukushima R, Yamane Y. Daily Rhythms of Left Atrial Pressure in Beagle Dogs with Mitral Valve Regurgitation. J Vet Intern Med 2009; 23:824-31. [PMID: 19496915 DOI: 10.1111/j.1939-1676.2009.0322.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- T Ishikawa
- Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Tokyo, Japan
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Sereda NC, Towl S, Maisenbacher HW, Bleweis MS, Levy JK, Byrne BJ, Ellison GW, Shih A, Coomer AR, Estrada AH. Intracardiac foreign body in a dog. J Vet Cardiol 2009; 11:53-8. [DOI: 10.1016/j.jvc.2009.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2008] [Revised: 02/25/2009] [Accepted: 03/06/2009] [Indexed: 10/20/2022]
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Rioja E, Beaulieu K, Holmberg DL. Anesthetic management of an off-pump open-heart surgery in a dog. Vet Anaesth Analg 2009; 36:361-8. [PMID: 19470140 DOI: 10.1111/j.1467-2995.2009.00465.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBSERVATIONS A 9 year-old, 40 kg, female spayed Bouvier des Flandres was anesthetized for surgical removal of an intra-cardiac mass. Pre-anesthetic work-up included thoracic radiographs, which revealed moderate pleural effusion, and cardiac ultrasound, which identified a mass attached to the wall of the right ventricular outflow tract (RVOT). The mass caused dynamic obstruction of the RVOT during systole. The dog was pre-medicated with intravenous (IV) hydromorphone (0.05 mg kg(-1)). Following pre-oxygenation, anesthesia was induced with ketamine (3.75 mg kg(-1), IV) and diazepam (0.18 mg kg(-1), IV). Anesthesia was maintained with isoflurane in oxygen, an intravenous constant rate infusion (CRI) of fentanyl (10-30 microg kg(-1) hour(-1)) and a CRI of lidocaine (50-200 microg kg(-1) minute(-1)). A right lateral thoracotomy was performed. The heart was stopped transiently with a cold cardioplegic solution for 7.83 minutes to allow the removal of the mass through an open-heart procedure. No cardiopulmonary bypass was used. The heart was successfully restarted after cardiopulmonary resuscitation with internal cardiac massage and internal defibrillation. The dog recovered uneventfully from anesthesia without any apparent neurological sequelae. Post-operative analgesia consisted of intercostal nerve blocks with bupivacaine, CRIs of fentanyl (2-5 microg kg(-1) hour(-1)) and lidocaine (40 microg kg(-1) minute(-1)) and with oral meloxicam (0.1 mg kg(-1)). Five days following surgery, the dog was discharged from the hospital. Histopathology and immunohistochemistry of the mass identified an ectopic thyroid carcinoma. CONCLUSIONS This case showed the feasibility of whole body hypothermia and using a cold cardioplegic solution to induce cardiac arrest for a short open-heart procedure.
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Affiliation(s)
- Eva Rioja
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
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Goggs R, Benigni L, Fuentes VL, Chan DL. Pulmonary thromboembolism. J Vet Emerg Crit Care (San Antonio) 2009; 19:30-52. [DOI: 10.1111/j.1476-4431.2009.00388.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Crosara S, Zabarino S, Morello E, Iussich S, Buracco P, Borgarelli M. Migration of a Kirschner wire to the heart in a Yorkshire terrier. J Small Anim Pract 2008; 49:100-2. [PMID: 17850280 DOI: 10.1111/j.1748-5827.2007.00426.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A 12-year-old, male Yorkshire terrier was presented for acute pulmonary oedema. Thoracic radiographs showed a linear metallic foreign body within the cardiac silhouette. Echocardiogram showed a hyperechoic line extending through the left ventricle, the mitral valve, leading into the left atrium. A 4 cm long Kirschner wire was surgically removed by left fourth thoracotomy. The dog died two days after surgery for acute pulmonary oedema. Necropsy showed thrombi on the mitral leaflets that impeded their movement.
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Affiliation(s)
- S Crosara
- Department of Animal Pathology, Faculty of Veterinary Medicine, University of Torino, 10095 Grugliasco, Torino, Italy
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Atkins CE, Keene BW, Brown WA, Coats JR, Crawford MA, DeFrancesco TC, Edwards NJ, Fox PR, Lehmkuhl LB, Luethy MW, Meurs KM, Petrie JP, Pipers FS, Rosenthal SL, Sidley JA, Straus JH. Results of the veterinary enalapril trial to prove reduction in onset of heart failure in dogs chronically treated with enalapril alone for compensated, naturally occurring mitral valve insufficiency. J Am Vet Med Assoc 2007; 231:1061-9. [DOI: 10.2460/javma.231.7.1061] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Arai S, Wright BD, Miyake Y, Boon JA, Orton EC. Heterotopic implantation of a porcine bioprosthetic heart valve in a dog with aortic valve endocarditis. J Am Vet Med Assoc 2007; 231:727-30. [PMID: 17764431 DOI: 10.2460/javma.231.5.727] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION A 5-year-old male German Shepherd Dog was evaluated because of a 5-month history of progressive lethargy, weight loss, and heart failure. CLINICAL FINDINGS On physical examination, bounding femoral pulses and systolic and diastolic murmurs were detected. Echocardiography revealed severe aortic valve insufficiency (AVI) and a large vegetative lesion on the aortic valve consistent with aortic valve endocarditis. The AVI velocity profile half-time was 130 milliseconds; the calculated peak systolic pressure gradient across the aortic valve was 64 mm Hg. Left ventricular diameter during diastole was 63.6 mm (predicted range, 40.2 to 42 mm) and during systole was 42.9 mm (predicted range, 25.4 to 27 mm). Systolic, diastolic, and mean arterial blood pressures were 120, 43, and 65 mm Hg, respectively. TREATMENT AND OUTCOME To palliate severe AVI, the descending aorta was occluded (duration, 16.75 minutes) and heterotopic implantation of a porcine bioprosthetic heart valve in that vessel was performed. After surgery, systolic, diastolic, and mean arterial blood pressures were 115, 30, and 61 mm Hg, respectively, in the forelimb and 110, 62, and 77 mm Hg, respectively, in the hind limb. Within 6 months, the AVI velocity profile half-time had increased to 210 milliseconds, indicating diminished severity of AVI. After 24 months, the dog was able to engage in vigorous exercise; no pulmonary edema had developed since surgery. CLINICAL RELEVANCE Heterotopic bioprosthetic heart valve implantation into the descending aorta during brief aortic occlusion appears feasible in dogs and may provide substantial palliation for dogs with severe AVI.
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Affiliation(s)
- Shiori Arai
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA
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Behr L, Chetboul V, Sampedrano CC, Vassiliki G, Pouchelon JL, Laborde F, Borenstein N. Beating Heart Mitral Valve Replacement with a Bovine Pericardial Bioprosthesis for Treatment of Mitral Valve Dysplasia in a Bull Terrier. Vet Surg 2007; 36:190-8. [PMID: 17461942 DOI: 10.1111/j.1532-950x.2007.00259.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To describe an open, beating heart surgical technique and use of a bovine pericardial prosthetic valve for mitral valve replacement (MVR) in the dog. STUDY DESIGN Clinical case report. ANIMALS Male Bull Terrier (17-month-old, 26 kg) with mitral valve dysplasia and severe regurgitation. METHODS A bovine pericardial bioprosthesis was used to replace the mitral valve using an open beating heart surgical technique and cardiopulmonary bypass. RESULTS Successful MVR was achieved using a beating heart technique. Mitral regurgitation resolved and cardiac performances improved (left ventricular end-diastolic diameter decreased from 57.6 to 48.7 mm, and left atrium/aorta ratio returned to almost normal, from 1.62 to 1.19). Cardiopulmonary by-pass time and total surgical duration were decreased compared with standard cardioplegic techniques. Surgical recovery was uneventful and on echocardiography 6 months later valve function was excellent. CONCLUSION Considering the technique advantages (no cardiac arrest, ischemic reperfusion injury, and hypothermia, or the need for aortic dissection and cannulation for administration of cardioplegic solution), short-term mortality and morbidity may be reduced compared with standard cardioplegic techniques. CLINICAL RELEVANCE Based on experience in this dog, beating heart mitral valvular replacement is a seemingly safe and viable option for the dog and bovine pericardial prosthesis may provide better long-term survival than mechanical prostheses.
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