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CLINICAL NEWS



              CLINICAL NEWS





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              Cardiothoracic surgery case: Amber’s story





                    ast September Amber,          team performed a mitral purse-string
                    a 10-year-old Yorkshire terrier   annuloplasty with pledgeted CV5 Gore-
                    cross, came for evaluation    Tex suture to bring the orifice where the
             Lby the Cardiology Service           valve sits back down to a normal size.
              and myxomatous mitral valve disease   Amber progressed very well after
              was confirmed. The possibility of    surgery and echocardiography
              being a candidate for mitral valve    confirmed that the repair was a success.
              repair was discussed.
                                                  She was discharged from hospital on
              Amber’s heart disease was stage     November 6th. A month after surgery
              C, meaning her heart was enlarged   Amber came in for post mitral valve
              secondary to her valvular disease   repair evaluation. Her energy levels had
              and that resulted in her developing   returned and her appetite had improved.
              congestive heart failure. Her valve   Echocardiography confirmed that the
              was severely affected and there was   valve repair was stable, there was trivial
              evidence of ruptured chords, which    residual mitral valve regurgitation and
              may have been responsible for a     no signs of clots or thrombi. The echo
              collapse weeks before.              measurements confirmed that Amber’s
                                                  heart had returned to a normal size.
              Amber returned to the RVC at the end
              of October for mitral valve repair, under   Amber was also examined at the RVC
              cardiopulmonary bypass. A left 5th   for her three-month post mitral valve
              intercostal thoracotomy was used to   repair evaluation and this confirmed that
              access the heart and a small approach   the repair was stable and her heart was
              to the left cervical region to isolate   functioning normally. Amber was doing
              the carotid artery for cannulation was   extremely well, off all medications and
              made. The mitral valve was accessed   enjoying life to the full.
              via a left atriotomy under conditions of
              cardiopulmonary bypass.
              Amber’s mitral valve was severely     The summer issue of the RVC’s
              diseased with thickening to all valve   Clinical Connections newsletter
              edges, stretching of all chords and a   includes an interview with Dan
              small fissure in the parietal valve leaflet.
                                                    Brockman about developments in
              Three artificial chords (Gore-Tex sutures)   the Cardiothoracic Surgery Service.
              were placed between the papillary     In that article Professor Brockman
              muscles and the edge of the septal valve   explains why other elements of the
              leaflets (CV 6), and two artificial chords   team, in addition to the surgeons,
              were placed in the P2 valve leaflet (CV   are vital to deliver an exceptional
              6). The fissure was closed with a single   service to dogs and their owners.  Amber with Dan Brockman
              suture of 6-0 prolene. In addition, the
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