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小型犬和玩赏犬的深低温体外循环心脏直视手术。

Open heart surgery with deep hypothermia and cardiopulmonary bypass in small and toy dogs.

作者信息

Kanemoto Isamu, Taguchi Daisuke, Yokoyama Satoko, Mizuno Masashi, Suzuki Hiromi, Kanamoto Tougaku

机构信息

Chayagasaka Animal Hospital, Nagoya, Japan.

出版信息

Vet Surg. 2010 Aug;39(6):674-9. doi: 10.1111/j.1532-950X.2010.00687.x. Epub 2010 Apr 29.

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.

摘要

目的

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。

研究设计

病例系列研究。

动物

体重<5.5 kg患有先天性心脏病的小型犬(n = 8)。

方法

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。

结果

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。

结论

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。

临床意义

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。

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