Bioprosthesis valve replacement in dogs with congenital tricuspid valve dysplasia: Technique and outcome

Shiori Arai, Leigh Griffiths, Khursheed Mama, Timothy B. Hackett, Eric Monnet, June A. Boon, Leslie Carter, E. Christopher Orton

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objective: To describe the surgical technique and report outcome of dogs undergoing bioprosthesis valve replacement for severe tricuspid regurgitation (TR) secondary to congenital tricuspid valve dysplasia (TVD). Animals, materials and methods: Twelve client-owned dogs (19-43 kg) with TVD underwent tricuspid valve replacement with a bovine pericardial or porcine aortic bioprosthesis with the aid of cardiopulmonary bypass. Anticoagulation with warfarin was maintained for 3 months after surgery and then discontinued. Results: Ten of 12 (83.3%) dogs survived surgery and were discharged from the hospital. Seven dogs were alive with complete resolution of TR for a median period of 48 months (range 1-66 months) after surgery. Two dogs underwent euthanasia because of bioprosthesis failure due to inflammatory pannus at 10 and 13 months after surgery. Two dogs experienced valve thrombosis that was resolved by tissue plasminogen activator. One dog developed suspected endocarditis after surgery that was resolved with antibiotics. Serious cardiac complications included atrial fibrillation and flutter, right-to-left shunt through an uncorrected patent foramen ovale, complete atrioventricular block, and sudden cardiac arrest. Postoperative atrial fibrillation or flutter did not occur in 7 dogs treated prophylactically with oral amiodarone before surgery. Conclusions: Curative intermediate-term outcomes are possible in dogs undergoing open tricuspid valve replacement with a bioprosthesis. Prosthesis-related complications include inflammatory pannus, thrombosis, and endocarditis. Postoperative atrial fibrillation or flutter can be reduced or prevented by prophylactic preoperative treatment with amiodarone. Several identified complications are avoidable or can be reduced with increased awareness and experience with these techniques.

Original languageEnglish (US)
Pages (from-to)91-99
Number of pages9
JournalJournal of Veterinary Cardiology
Volume13
Issue number2
DOIs
StatePublished - Jun 1 2011
Externally publishedYes

Fingerprint

Bioprosthesis
Tricuspid Valve
Dogs
surgery
dogs
Atrial Flutter
Atrial Fibrillation
Tricuspid Valve Insufficiency
endocarditis
Amiodarone
thrombosis
methodology
Endocarditis
Thrombosis
t-plasminogen activator
warfarin
Patent Foramen Ovale
cardiac arrest
prostheses
Euthanasia

Keywords

  • Bioprosthesis
  • Dog
  • Tricuspid regurgitation
  • Tricuspid valve dysplasia

ASJC Scopus subject areas

  • Physiology
  • veterinary(all)

Cite this

Bioprosthesis valve replacement in dogs with congenital tricuspid valve dysplasia : Technique and outcome. / Arai, Shiori; Griffiths, Leigh; Mama, Khursheed; Hackett, Timothy B.; Monnet, Eric; Boon, June A.; Carter, Leslie; Orton, E. Christopher.

In: Journal of Veterinary Cardiology, Vol. 13, No. 2, 01.06.2011, p. 91-99.

Research output: Contribution to journalArticle

Arai, Shiori ; Griffiths, Leigh ; Mama, Khursheed ; Hackett, Timothy B. ; Monnet, Eric ; Boon, June A. ; Carter, Leslie ; Orton, E. Christopher. / Bioprosthesis valve replacement in dogs with congenital tricuspid valve dysplasia : Technique and outcome. In: Journal of Veterinary Cardiology. 2011 ; Vol. 13, No. 2. pp. 91-99.
@article{e9473b2f7bbd4c3c9810675336c1a6a0,
title = "Bioprosthesis valve replacement in dogs with congenital tricuspid valve dysplasia: Technique and outcome",
abstract = "Objective: To describe the surgical technique and report outcome of dogs undergoing bioprosthesis valve replacement for severe tricuspid regurgitation (TR) secondary to congenital tricuspid valve dysplasia (TVD). Animals, materials and methods: Twelve client-owned dogs (19-43 kg) with TVD underwent tricuspid valve replacement with a bovine pericardial or porcine aortic bioprosthesis with the aid of cardiopulmonary bypass. Anticoagulation with warfarin was maintained for 3 months after surgery and then discontinued. Results: Ten of 12 (83.3{\%}) dogs survived surgery and were discharged from the hospital. Seven dogs were alive with complete resolution of TR for a median period of 48 months (range 1-66 months) after surgery. Two dogs underwent euthanasia because of bioprosthesis failure due to inflammatory pannus at 10 and 13 months after surgery. Two dogs experienced valve thrombosis that was resolved by tissue plasminogen activator. One dog developed suspected endocarditis after surgery that was resolved with antibiotics. Serious cardiac complications included atrial fibrillation and flutter, right-to-left shunt through an uncorrected patent foramen ovale, complete atrioventricular block, and sudden cardiac arrest. Postoperative atrial fibrillation or flutter did not occur in 7 dogs treated prophylactically with oral amiodarone before surgery. Conclusions: Curative intermediate-term outcomes are possible in dogs undergoing open tricuspid valve replacement with a bioprosthesis. Prosthesis-related complications include inflammatory pannus, thrombosis, and endocarditis. Postoperative atrial fibrillation or flutter can be reduced or prevented by prophylactic preoperative treatment with amiodarone. Several identified complications are avoidable or can be reduced with increased awareness and experience with these techniques.",
keywords = "Bioprosthesis, Dog, Tricuspid regurgitation, Tricuspid valve dysplasia",
author = "Shiori Arai and Leigh Griffiths and Khursheed Mama and Hackett, {Timothy B.} and Eric Monnet and Boon, {June A.} and Leslie Carter and Orton, {E. Christopher}",
year = "2011",
month = "6",
day = "1",
doi = "10.1016/j.jvc.2010.12.002",
language = "English (US)",
volume = "13",
pages = "91--99",
journal = "Journal of Veterinary Cardiology",
issn = "1760-2734",
publisher = "Elsevier",
number = "2",

}

TY - JOUR

T1 - Bioprosthesis valve replacement in dogs with congenital tricuspid valve dysplasia

T2 - Technique and outcome

AU - Arai, Shiori

AU - Griffiths, Leigh

AU - Mama, Khursheed

AU - Hackett, Timothy B.

AU - Monnet, Eric

AU - Boon, June A.

AU - Carter, Leslie

AU - Orton, E. Christopher

PY - 2011/6/1

Y1 - 2011/6/1

N2 - Objective: To describe the surgical technique and report outcome of dogs undergoing bioprosthesis valve replacement for severe tricuspid regurgitation (TR) secondary to congenital tricuspid valve dysplasia (TVD). Animals, materials and methods: Twelve client-owned dogs (19-43 kg) with TVD underwent tricuspid valve replacement with a bovine pericardial or porcine aortic bioprosthesis with the aid of cardiopulmonary bypass. Anticoagulation with warfarin was maintained for 3 months after surgery and then discontinued. Results: Ten of 12 (83.3%) dogs survived surgery and were discharged from the hospital. Seven dogs were alive with complete resolution of TR for a median period of 48 months (range 1-66 months) after surgery. Two dogs underwent euthanasia because of bioprosthesis failure due to inflammatory pannus at 10 and 13 months after surgery. Two dogs experienced valve thrombosis that was resolved by tissue plasminogen activator. One dog developed suspected endocarditis after surgery that was resolved with antibiotics. Serious cardiac complications included atrial fibrillation and flutter, right-to-left shunt through an uncorrected patent foramen ovale, complete atrioventricular block, and sudden cardiac arrest. Postoperative atrial fibrillation or flutter did not occur in 7 dogs treated prophylactically with oral amiodarone before surgery. Conclusions: Curative intermediate-term outcomes are possible in dogs undergoing open tricuspid valve replacement with a bioprosthesis. Prosthesis-related complications include inflammatory pannus, thrombosis, and endocarditis. Postoperative atrial fibrillation or flutter can be reduced or prevented by prophylactic preoperative treatment with amiodarone. Several identified complications are avoidable or can be reduced with increased awareness and experience with these techniques.

AB - Objective: To describe the surgical technique and report outcome of dogs undergoing bioprosthesis valve replacement for severe tricuspid regurgitation (TR) secondary to congenital tricuspid valve dysplasia (TVD). Animals, materials and methods: Twelve client-owned dogs (19-43 kg) with TVD underwent tricuspid valve replacement with a bovine pericardial or porcine aortic bioprosthesis with the aid of cardiopulmonary bypass. Anticoagulation with warfarin was maintained for 3 months after surgery and then discontinued. Results: Ten of 12 (83.3%) dogs survived surgery and were discharged from the hospital. Seven dogs were alive with complete resolution of TR for a median period of 48 months (range 1-66 months) after surgery. Two dogs underwent euthanasia because of bioprosthesis failure due to inflammatory pannus at 10 and 13 months after surgery. Two dogs experienced valve thrombosis that was resolved by tissue plasminogen activator. One dog developed suspected endocarditis after surgery that was resolved with antibiotics. Serious cardiac complications included atrial fibrillation and flutter, right-to-left shunt through an uncorrected patent foramen ovale, complete atrioventricular block, and sudden cardiac arrest. Postoperative atrial fibrillation or flutter did not occur in 7 dogs treated prophylactically with oral amiodarone before surgery. Conclusions: Curative intermediate-term outcomes are possible in dogs undergoing open tricuspid valve replacement with a bioprosthesis. Prosthesis-related complications include inflammatory pannus, thrombosis, and endocarditis. Postoperative atrial fibrillation or flutter can be reduced or prevented by prophylactic preoperative treatment with amiodarone. Several identified complications are avoidable or can be reduced with increased awareness and experience with these techniques.

KW - Bioprosthesis

KW - Dog

KW - Tricuspid regurgitation

KW - Tricuspid valve dysplasia

UR - http://www.scopus.com/inward/record.url?scp=79959379299&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79959379299&partnerID=8YFLogxK

U2 - 10.1016/j.jvc.2010.12.002

DO - 10.1016/j.jvc.2010.12.002

M3 - Article

C2 - 21640677

AN - SCOPUS:79959379299

VL - 13

SP - 91

EP - 99

JO - Journal of Veterinary Cardiology

JF - Journal of Veterinary Cardiology

SN - 1760-2734

IS - 2

ER -