Page 7 - Clinical Connections - Summer 2024
P. 7

Heart surgery
                                                                                stretching of all chords and a small fissure in
                                                                                the parietal valve leaflet.
                                                                                 Three artificial chords (Gore-Tex sutures)
                                                                                were placed between the papillary muscles
                                                                                and the edge of the septal valve leaflets (CV
                                                                                6), and two artificial chords were placed in
                                                                                the P2 valve leaflet (CV 6). The fissure was
                                                                                closed with a single suture of 6-0 prolene. In
                                                                                addition, we performed a mitral purse-string
                                                                                annuloplasty  with  pledgeted  CV5  Gore-Tex
                                                                                suture to bring the orifice where the valve sits
                                                                                back down to a normal size.
                                                                                 Amber progressed very well after surgery
                                                                                and  echocardiography  confirmed  that
                                                                                the  repair  was  a  success.  She  was
                                                                                discharged from hospital on November
                                                                                6th.
                                                                                 A  month  after  surgery  Amber  came  in
         Members of the Cardiothoracic Surgery Service                          for  post  mitral  valve  repair  evaluation.  Her
                                                                                energy levels had returned and her appetite
        Technology                          mitral  valve  disease  was  confirmed.  The   had improved. Echocardiography confirmed
        In addition to human expertise, technology   possibility of being a candidate for mitral
        is critical to what we do. We are fortunate to   valve repair was discussed.   Amber with Dan Brockman
        have a brand new cardiopulmonary bypass   Amber's  heart  disease  was  stage  C,
        console  (heart-lung  machine),  which  was   meaning her heart was enlarged secondary
        purchased  through  donations  to  the  RVC   to her valvular disease and that resulted in
        Animal  Care Trust  that  were  restricted  for   her developing congestive heart failure. Her
        use  in  the  development  of  heart  surgery.   valve was severely affected and there was
        This is the machine that circulates the blood   evidence  of  ruptured  chords,  which  may
        once the heart is bypassed and we have it   have been responsible for a collapse weeks
        open.                               before.
        The ACT also provided funds to purchase   Amber  returned  to  the  RVC  at  the
        surgical  loupes  for  Matteo.  These  are  an   end  of  October  for  mitral  valve  repair,
        essential  piece  of  equipment  but  they  are   under  cardiopulmonary  bypass.  A  left  5th
        extremely expensive so we are very grateful   intercostal thoracotomy was used to access
        to the RVC’s Animal Care Trust and donors   the heart and a small approach to the left
        supporting our work.                cervical  region  to  isolate  the  carotid  artery
                                            for cannulation was made. The mitral valve
        Amber's story                       was  accessed  via  a  left  atriotomy  under
        Last  September  Amber,  a  10-year-old   conditions of cardiopulmonary bypass.
        Yorkshire terrier cross, came for evaluation   Amber’s  mitral  valve  was  severely   that the valve repair was stable, there was
        by the Cardiology Service and myxomatous   diseased with thickening to all valve edges,   trivial  residual  mitral  valve  regurgitation
                                                                                and no signs of clots or thrombi. The echo
                                                 Amber at RVC Small Animal Referrals   measurements confirmed that Amber's heart
                                                                                had returned to a normal size.
                                                                                 Amber  was  also  examined  at  the  RVC
                                                                                for her three-month post mitral valve repair
                                                                                evaluation and this confirmed that the repair
                                                                                was  stable  and  her  heart  was  functioning
                                                                                normally. Amber  was  doing  extremely  well,
                                                                                off all medications and enjoying life to the full.









                                                                                       For small animal referrals, please call:
                                                                                     01707 666399
                                                                                       Email:
                                                                                     qmhreception@rvc.ac.uk


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