Brockman et al Vet Surg 2025 -
What was key into improving outcomes in an institution starting a mitral valve repair program?
What were the findings in regards to short term outcome over time?
Structured organized team with consistent personnel resulted in an improvement in outcome over time.
A consistent trend of improved short-term outcome was observed, with survival rate of 22/33 in the first quartile (67%), 27/33 in the second quartile (88%), 28/33 in the third quartile (85%) and 30/33 dogs in the fourth quartile (91%).
- The breeds most represented were Cavalier King Charles Spaniels and Chihuahuas
- The MMVD was categorized clinically as stage D in 27%, stage C in 67% and stage B2 in 6% affected dogs
- Overall, 81% of dogs survived to discharge
Galliano et al Vet Surg 2022-
In regards to subcutaneous vascular ports placed at the time of limb amputation in dogs:
Where were they placed?
What was the outcome?
What was the most common complication?
- Jugular, axillary or femoral/ external iliac
- The axillary and femoral vein placement during amputation was at least as safe as jugular placement
- Infection (no difference in complication rate was detected between groups)
Mickelson et al Vet Surg 2021-
In feline renal transplant is the use of a microvascular anastomotic coupler end to end feasible?
It worked in healthy cats and was faster than hand sewing with minimal blood loss.
To describe technique and determine the feasibility of an end-to-side anastomosis of the renal vein to vena cava; renal artery to aorta using microvascular anastomotic coupler (MAC) for feline renal transplant
▪ In vivo experimental (n=6 purpose bred cats). 3.5 mm for vena cava (purple); 1.5 mm for aorta (blue)
Results:
o Anastomosis successful in all cats with negligible intra-op hemorrhage
o 1/6 euthanized due to post op hemoabdomen (16%)
o Renal perfusion and resistive index (RI) within normal range 5/6 (83%), similar to the contralateral normal kidneys
Mihara et al Vet Surg 2024-
What effect does mitral valve repair have on geometry of the mitral valve complex and cardiac function?
The MV repair caused the creation of a coaptation length of >5 mm from un-detectable.
This limited the range of motion of the leaflets in the vertical plane and stabilized the annular geometry which allowed cardiac chamber size to decrease in < 1 week and ultimately lead to decreased need for medications.
Raleigh et al Vet Surg 2022-
What complication occurred with pericardectomy and how frequently did it occur?
Ventricular fibrillation - was found to be rare and most often fatal complication in pericardectomy cases
In total 456 peri- cardiectomies were performed at institutions from which 14 cases were submitted. Estimated incidence of VF during pericardiectomy can therefore be estimated to have occurred in 14/456 (3%) pericardiectomy procedures.
2/16 survived (88% mortality; 12% survived) despite 13/16 (81%) being defibrillated
Possibly due to electrosurgical device of cardiac manipulation (no causal link established)
- Indications for pericardiectomy included idiopathic chylothorax (n= 7), neoplasia (n= 4), idiopathic pericardial effusion (n= 4), and foreign body granuloma (n= 1).
- Surgical approaches included thoracoscopy (12), intercostal thoracotomy (3) and median sternotomy (1).
- Electrosurgical devices were used to complete at least part of the pericardiectomy in 15 of 16 dogs (93%).
- Ventricular fibrillation appeared to be initiated during electrosurgical use in 8/15 dogs (52%). However, in 5/15 (33%) dogs it was not obviously associated with electrosurgical use.
- In 3/16 dogs (19%) the timing of initiation of VF was unclear.
- In 7/16 dogs (44%), cardiac arrhythmias were noted prior to the development of VF.
- Fourteen of 16 dogs died from intraoperative VF (88%)
Rossanese et al JSAP 2022-
What were the treatment options for double aortic arch?
Prognosis?
What was the most common dominant aorta?
- Ligation and transection of the lesser aortic arch via a left 4th intercostal thoracotomy
- Excellent outcomes with only minor impact on QoL
- Right
*** Surgical ligation of the lesser aortic arch in dogs and cats with double aortic arch was associated with a favorable prognosis for recovery, resolution of clinical signs and quality of life with only minor feeding modifications
Rossanese et al JAVMA 2024-
In regards to canine epicardial pacemakers:
- Most common indication?
- Complication rate?
- Survival rate?
- 75% was due to 3rd degree AV block
*** Common reasons for EP placement included previous transvenous pacemaker dislodgement/loss of capture and small body size - Intra-op complication 11%
- Post-op complication 23%
-Survival to discharge 96%
NOTE:
Various negative prognostic factors for dogs undergoing endocardial PM implantation have been reported, including age, high serum troponin I concentration, severe azotemia, the use of a secondhand PM, presence of CHF, the occurrence of complications and a concurrent cardiac disease
Rossanese et al JAVMA 2025-
In regards to feline epicardial pacemakers:
- Most common indication?
- Complication rate?
- Survival rate?
- 74% was due to 3rd AV block
- Intra-op complications 8%
- Post-op complications 35%
- Survival to discharge 100%
The primary reasons for referral included collapsing episodes (n=27; 69%) and bradycardia (n= 31; 79%)
Scheuermann et al Vet Surg 2020-
What was the main finding of the systematic review?
No one treatment of pericardial effusion is superior to another
Shriwise et al Vet Surg 2021-
What vessels were anastomosed with a microvascular anastomosis coupler device in healthy beagles?
Caudal thoracic duct and intercostal vein (11th or 12th intercostal vein)
*** This can be a treatment option for idiopathic chylothorax, to reduce stimulus for collateral circulation and persistent flow to the cranial mediastinal lymphatics.
*** Microvascular anastomotic coupler comes in two sizes 1.5mm and 2mm diameters.
Welker et al Vet Surg 2024-
Coupling the caudal thoracic duct to the 10th or 11th intercostal vein with a microvascular coupling device:
Success rate PO?
Success rate at 30 days?
Cause of occlusion
- 100%
- The anastomosis was patent in 4/6 dogs (66%)
- Kinking of the intercostal vein just cranial to the MAC
Blanco VRU 2024-
What were some of the CT findings in cats and dogs that had heart base tumors?
Neuroendocrine tumors (ie: aortic body tumors, ectopic thyroid carcinoma and nonspecific neuroendocrine) were more commonly observed than hemangiosarcoma.
Neuroendocrine tumors were frequently located between the cranial vena cava and aortic arch (12/21; 57%) and or dorsal to the pulmonary trunk bifurcation/pulmonary arteries (10/21; 48%)
Hemangiosarcoma was more commonly found cranioventral to the aortic arch and cranial to the right auricular appendage (3/4; 75%)
Mediastinal and peritumoral neovascularization was associated with 16/21 (76%) neuroendocrine tumors but none of the hemangiosarcoma
Median postcontrast attenuation in Hounsfield units was higher in neuroendocrine (110 HU) than in hemangiosarcoma (51 HU)
Pericardial effusion was frequently observed with hemangiosarcoma (3/4; 75%) and infrequently in neuroendocrine (3/21; 14%)
Grimes Vet Surg 2022-
Surgical ligation of PDA in dogs…
What was the incidence for rupture?
Risk factors for rupture?
Mortality rate?
Residual flow?
● 7% rupture, no difference in age or weight (no risk factors identified for rupture)
● 0.4% mortality
● 9.4% residual flow
Note:
** Dogs with rupture were more likely to have residual flow than those without rupture.
** If ligation was performed after rupture (rather than hemostasis only), no difference in residual flow rates was noted between dogs with rupture and those without.
Hildebrandt JVIM 2022-
What device was evaluated for transvenous embolization in moderate to large PDA in dogs?
What was the closure rate 24 hours post-op?
What was the closure rate 3 months post-op?
- Amplatzer vascular plug II
- Closure rate 24 hours post 94.7%
- Closure rate 3 months post 100%
The AVP-II is a safe and effective device for transvenous embolization in dogs with moderate to large PDA (>2.5 mm).
Moirano VRU 2023-
What treatment was evaluated for canine right atrial tumors?
What was the response rate to this treatment?
Median progression free survival time?
Median overall survival time?
Hypofractionated chemoradiotherapy - Patients had hypofractionated intensity modulated radiotherapy and concurrent vinblastine and propranolol
- 1 dog (14%) had a complete response, 4 dogs (57%) had partial responses and 2 dogs (29%) had stable disease after treatment
- Effusions resolved in all dogs (100%)
- Median progression-free survival was 290 days
- Median overall survival time was 326 days
Shua-Haim VRU 2023-
What diagnostic was used to further investigate double aortic arches in dogs?
Clinical signs with double aortic arch?
CT features of double aortic arch?
CT angiography
The most common clinical signs include:
○ Chronic regurgitation (100%)
○ Decreased body condition score (67%)
○ Coughing (50%)
Common CTA features of DAA included a:
○ Dominant left aortic arch (median diameter 8.1mm) and minor right aortic arch (median diameter 4.3mm)
○ An aberrant right subclavian artery arising directly from the right aortic arch (83%)
○ Segmental esophageal constriction (100%)
○ Variable degrees of dilation cranial to the heart base
○ Marked tracheal luminal compression and leftward curvature of the trachea at the level of the bifurcation of the aortic arches (100%)
*** All dogs underwent successful surgical correction with only minor postoperative complications
Rossie JAVMA 2024-
What new vascular ring anomaly in dogs was identified?
What were the CT findings associated with this vascular ring anomaly?
What other congenital anomalies were found with this one?
- Circumflex left aortic arch
- CT revealed a normal leftward oriented cranial half and an abnormal caudal half of the aortic arch crossing toward the right dorsal hemithorax leading to esophageal constriction in all dogs
- In addition, 1 dog presented with a right patent ductus arteriosus and 1 with an aberrant right subclavian artery
NOTE:
* Clinical signs include postprandial regurgitation and poor growth
* Circumflex left aortic arch vascular ring anomaly cannot be surgically corrected via the left thoracotomy that is commonly used for the more common vascular ring anomalies in dogs
Costanza VRU 2023-
What new objective method for radiographic assessment of cardiac silhouette size was evaluated in dogs?
Heart to single vertebra ratio
** The lengths of the vertebral bodies, from the 4th to 8th thoracic vertebra and VHS were measured on each radiograph
** The HSVR was calculated by dividing the sum of the cardiac long and short axes by the length of each vertebral body
McNamara JAVMA 2023-
Risk factors for intraoperative hemorrhage during surgical PDA ligation in dogs?
Perioperative complications?
Short and long term outcomes?
*** The majority of dogs undergoing surgical intervention for a left to right shunting PDA were female (74%), small breed dogs <1 year of age, which is consistent with previous reports
*** There was no association between age, weight or increasing left atrium-to-aortic ratio and intraoperative hemorrhage- 65% dogs had evidence of mitral regurgitation at presentation; however, there was no correlation between presence or degree of MR and an increased risk of intraoperative hemorrhage
*** Intraoperative hemorrhage occurred in 11% of patients
*** Intraoperative mortality was 2%
*** 95% of dogs experiencing intraoperative hemorrhage survived to discharge
*** Survival to discharge was 97%
*** 1 and 5 year survival rates were 96% and 87%
Pennington JAVMA 2024-
Did owner quality of life improve following surgical repair of canine myxomatous mitral valve disease?
There was a statistically significant improvement in quality of life scores from preoperatively up to 3 months postoperatively and a statistically significant improvement in individual question scores up to 6 months postoperatively
*** Results suggested that owner quality of life is significantly improved following surgical repair of their pet’s myxomatous mitral valve disease and this improvement continues beyond the immediate postoperative period
Kurogochi JVIM 2025-
What were the findings related to transesophageal echocardiography use during mitral valve repair in dogs?
Of the 60 dogs, newly detected mucosal lesions were observed in 20 dogs (33%) and classified as “minor” in four (6%; saw petechia) and “minute” in 16 dogs (27%)
Complex- intramural hematoma, mucosal laceration
Minor- petechia, ecchymosis
Minute- Injury only visible on NBI mode
No significant factors were associated with the presence of mucosal lesions
After transesophageal echocardiography insertion, systolic blood pressure decreased from 95 mmHg to 92 mmHg and heart rate decreased from 128 bpm to 123 bpm
** Intraoperative TEE results in a low incidence of esophageal mucosal injuries
** Hemodynamic changes could occur during TEE manipulation, underscoring the need for close monitoring
Levine Vet Surg 2025-
What surgical approach was used for pericardial resection in dogs?
Intercostal thoracoscopic pericardiectomy in left lateral recumbency (compared it to the traditional transdiaphragmatic paraxiphoid approach in dorsal recumbency).
- Total surgical time (sum of approach and pericardiectomy time) did not differ between groups, although PDR pericardiectomy took longer by an average of 5.2 minutes
- Exteriorization of the heart from the pericardial sac was achieved for all trials
- Pericardial fragments from PDR trials were larger than those of ILR, with a mean difference of 23.21 cm^2
- Cardiac exposure and operative visibility scores were greater for paraxiphoid approach in dorsal recumbency procedures
*** The ILR approach with bilateral ventilation was a feasible alternative for performing partial pericardiectomies, which did not require more total surgical time when compared with the PDR approach
