Aoki Takuma, Miyamoto Takashi, Fukamachi Naoyuki, Niimi Seiya, Jingya Yao, Wakao Yoshito
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.
Animals (Basel). 2022 Jun 27;12(13):1653. doi: 10.3390/ani12131653.
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.
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。
