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改良环路技术与德维加瓣环成形术联合应用于二尖瓣反流犬的研究

Combination of the Modified Loop Technique and De Vega Annuloplasty in Dogs with Mitral Regurgitation.

作者信息

Aoki Takuma, Miyamoto Takashi, Fukamachi Naoyuki, Niimi Seiya, Jingya Yao, Wakao Yoshito

机构信息

Laboratory of Small Animal Surgery, Department of Veterinary Medicine, School of Veterinary Medicine, Azabu University, Sagamihara 252-5201, Kanagawa, Japan.

Department of Cardiology and Respieratory Disease, Azabu University Veterinary Teaching Hospital, Azabu University, Sagamihara 252-5201, Kanagawa, Japan.

出版信息

Animals (Basel). 2022 Jun 27;12(13):1653. doi: 10.3390/ani12131653.

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.

摘要

背景

此前尚未报道过治疗犬二尖瓣反流的详细手术技术。方法:本病例系列包括6只连续的家养患二尖瓣反流的犬。所有犬于2021年接受了包括改良袢环技术和德维加瓣环成形术(MODEL手术)的联合方案。使用覆盖腱索长度80%的人工袢进行腱索置换。二尖瓣瓣环成形术主观上针对间隔叶的周长进行。结果:品种包括吉娃娃混血、博美犬、波美拉尼亚犬、骑士查理王小猎犬和吉娃娃,平均年龄和体重分别为11.4±2.3岁和5.49±2.98千克。主动脉阻断、体外循环和手术时间分别为64.0±7.5分钟、168.5±39.1分钟和321.0±53.1分钟。MODEL手术后,左心房与主动脉比值从2.20±0.18显著降至1.26±0.22(p<0.01),左心室舒张末期内径与体重的比值从2.03±0.26显著降至1.48±0.20(p<0.01)。在所有病例中,临床症状消失或显著改善。结论:MODEL手术增加了二尖瓣的对合,使心脏大小恢复正常,并显著改善了二尖瓣反流犬的临床症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbc8/9264785/e61823541921/animals-12-01653-g001.jpg

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