Mitral valve replacement in dogs. Surgical technique and postoperative management

Although techniques for the perioperative management of patients undergoing mitral valve replacement have been well established in humans, the use of these techniques has not been widely accepted in veterinary practice. The purpose of this study is to demonstrate that low morbidity and mortality could be achieved in the dog undergoing mitral valve replacement. Nine mongrel dogs (25-45 kg body weight) were subject to left thoracotomy and mitral valve replacement using cardiopulmonary bypass (CPB). The average time on CPB was 1 hour with an aortic cross-clamping time of 40 minutes using chemically induced cardiac arrest. CPB was performed under conditions of moderate systemic hypothermia (28-30 degrees C) and hemodilution (hematocrit, 25-35%). Operative mortality was 22% (2/9) with one death from excessive bleeding and the other from cerebral air embolism. All other animals recovered and were clinically normal 3 weeks after surgery. The authors conclude that successful mitral valve replacement is possible in the large dog.