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Treatment of severe mitral regurgitation caused by lesions in both leaflets using multiple mitral valve plasty

Satoko Yokoyama1,2, Isamu Kanemoto1, Kippei Mihara1

  • 1Chayagasaka Animal Hospital, 1-1-5 Shinnishi, Chikusa, Nagoya, Aichi, 464-0003 Japan.

Open Veterinary Journal
|December 5, 2017
PubMed

Insights

Mitral valve plasty (MVP) is a preferred treatment for mitral regurgitation. A novel surgical technique using direct scallop suture successfully repaired complex posterior leaflet lesions in a small dog, offering a promising alternative to valve replacement.

Area of Science:

  • Veterinary Cardiology
  • Cardiac Surgery
  • Small Animal Medicine

Background:

  • Mitral valve plasty (MVP) is favored over mitral valve replacement (MVR) in humans due to better quality of life outcomes.
  • Repairing complex mitral valve lesions, particularly in small dogs, presents significant surgical challenges.
  • Severe mitral regurgitation in small canines often necessitates consideration of MVR.

Observation:

  • A mixed Chihuahua presented with severe mitral regurgitation due to multiple extensive lesions on the posterior leaflet.
  • Initial treatment strategy considered MVR with a prosthetic valve.
  • A modified MVP approach was employed, including artificial chordal reconstruction, annuloplasty, and a novel direct scallop suture for the posterior leaflet.

Findings:

  • The canine patient successfully recovered from the complex MVP procedure and subsequent cardiac operations.
  • The dog remained free of adverse cardiac signs post-surgery.
  • The patient survived for 4 years and 10 months, succumbing to non-cardiovascular disease.

Implications:

  • The direct scallop suture technique appears effective for repairing multi-scallop posterior leaflet lesions in small dogs.
  • This modified MVP approach offers a viable alternative to MVR in challenging small animal cases.
  • The long-term survival suggests the durability and success of this innovative surgical repair.
Keywords:
Chordal reconstructionDogMitral regurgitationMultiple direct scallop sutureSemi-circular suture annuloplasty

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