Kanemoto Isamu, Taguchi Daisuke, Yokoyama Satoko, Mizuno Masashi, Suzuki Hiromi, Kanamoto Tougaku
Chayagasaka Animal Hospital, Nagoya, Japan.
Vet Surg. 2010 Aug;39(6):674-9. doi: 10.1111/j.1532-950X.2010.00687.x. Epub 2010 Apr 29.
To evaluate open heart surgery with deep surface-induced hypothermia (sHT) and low-flow cardiopulmonary bypass (CPB) in small and toy-breed dogs.
Case series.
Small breed dogs (n=8) weighing <5.5 kg with naturally occurring cardiac disease.
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.
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.
Deep sHT with low-flow rate CPB may be used for open heart surgery in small dogs weighing <5.5 kg.
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.
评估在小型犬和玩赏犬中采用体表深部低温（sHT）和低流量体外循环（CPB）进行心脏直视手术的效果。
病例系列研究。
体重<5.5 kg患有先天性心脏病的小型犬（n = 8）。
采用异氟烷麻醉下的深部sHT以及使用小容量预充回路的低流量CPB。2只犬直接闭合室间隔缺损，5只犬通过二尖瓣成形术（MVP）纠正严重二尖瓣反流，1只犬进行二尖瓣置换术。
所有犬均存活至手术结束；1只犬在MVP术后6天死亡，1只在术后2个月死亡。其余6只犬存活（平均随访32.8个月；范围12 - 65个月）。手术时平均体重为3.6 kg（范围2 - 5.3 kg）。平均最低食管温度为21.4℃（范围19.8 - 23.8℃）。在主动脉阻断期间（平均53.5分钟；范围25 - 79分钟），平均最低泵流量为29.2 mL/kg/min（范围9.4 - 57.7 mL/kg/min）。CPB前平均血细胞比容为38.6%（范围33 - 47%），CPB期间为20.3%（范围13 - 24%），小回路预充量为225 - 260 mL。
低流量CPB联合深部sHT可用于体重<5.5 kg的小型犬心脏直视手术。
对于小型犬和玩赏犬中选定的先天性和后天性缺陷，采用深部sHT和CPB可成功进行心脏直视手术。
