JASMINE Veterinary Cardiovascular Medical Center, 2-7-3 Nakagawa, Tsuzuki, Yokohama, Kanagawa 224-0001, Japan.
Laboratory of Molecular Biology, Azabu University School of Veterinary Medicine, 1-17-71 Fuchinobe, Chuoku, Sagamihara, Kanagawa 252-5201, Japan.
J Vet Cardiol. 2020 Jun;29:33-39. doi: 10.1016/j.jvc.2020.03.001. Epub 2020 Mar 20.
Unilateral diaphragmatic paralysis (UDP) due to phrenic nerve injury is a potential complication of thoracic surgery. This study evaluated the prevalence of UDP associated with surgical mitral valve repair (MVR) and its effect on surgical outcomes in dogs.
ANIMALS, MATERIALS AND METHODS: Two hundred ninety-four dogs that underwent MVR were included in the study. A retrospective review of medical records was performed for dogs surviving surgery. Diagnosis of UDP was based on preoperative and postoperative thoracic dorsoventral radiographs.
A total of 284 dogs survived until the day after surgery. The prevalence of UDP on the day after surgery, on the day of discharge, and after the first postoperative month was 30%, 24%, and 9%, respectively. One case of UDP was observed at 3 months after surgery. Unilateral diaphragmatic paralysis was exhibited by nine of the 21 patients that died in the hospital. The proportion of patients with UDP was higher in dogs that died of respiratory failure than in dogs that died of other causes (p = 0.002). Most dogs whose deaths were suspected to have been related to respiratory failure also had pre-existing respiratory diseases. The occurrence of UDP did not relate to the lengths of stay in the intensive care unit or the hospital.
Our findings suggest that UDP is a common complication in dogs after MVR and that the prevalence of UDP decreases with time after surgery. Unilateral diaphragmatic paralysis is a risk factor for postoperative death, especially in patients with pre-existing respiratory disease.
膈神经损伤导致的单侧膈肌麻痹（UDP）是胸部手术的潜在并发症。本研究评估了外科二尖瓣修复术（MVR）相关 UDP 的发生率及其对犬手术结果的影响。
动物、材料和方法：研究纳入了 294 只接受 MVR 的犬。对手术后存活的犬进行了病历回顾。根据术前和术后的胸部背腹位 X 线片诊断 UDP。
共有 284 只犬存活至手术后的第二天。术后第 1 天、出院当天和术后第 1 个月 UDP 的发生率分别为 30%、24%和 9%。术后 3 个月观察到 1 例 UDP。21 例在院死亡的犬中，有 9 例出现 UDP。死于呼吸衰竭的犬中 UDP 的比例高于死于其他原因的犬（p=0.002）。大多数被怀疑与呼吸衰竭相关的死亡犬都有先前存在的呼吸系统疾病。UDP 的发生与重症监护病房或医院的住院时间无关。
我们的研究结果表明，UDP 是 MVR 后犬的常见并发症，且 UDP 的发生率随术后时间的推移而降低。单侧膈肌麻痹是术后死亡的一个危险因素，尤其是在存在先前存在的呼吸系统疾病的患者中。
