title: Echoguided closed commissurotomy for mitral valve stenosis in a dog.
abstract: Surgical treatment of mitral stenosis (MS) usually consists of open mitral commissurotomy (MC) or percutaneous balloon MC, which require a cardiopulmonary bypass or transseptal approach, respectively. We describe here the first surgical management of congenital MS in a dog using a less invasive procedure, a surgical closed MC under direct echo guidance. A 5-year-old female Cairn terrier was referred for ascites, weakness, and marked exercise intolerance for 2 months, which was refractory to medical treatment. Diagnosis of severe MS associated with atrial fibrillation (AF) was confirmed by echo-Doppler examination and electrocardiography. Poor response to medical treatment suggested a corrective procedure on the valve was indicated. However, due to the cost and high mortality rate associated with cardiopulmonary bypass, a hybrid MC was recommended. A standard left intercostal thoracotomy was performed and three balloon valvuloplasty catheters of differing diameters were sequentially inserted through the left atrium under direct echo guidance. Transesophageal echocardiography revealed a 62% reduction in the pressure half-time compared to the pre-procedure. Thirteen months after surgery the dog is still doing well with resolution of ascites and a marked improvement of most echo-Doppler variables.
authors.affiliation: Unité de Cardiologie d'Alfort, CHUVA, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort cedex, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Trehiou-Sechi
authors.forename: Luc
authors.initials: L
authors.lastname: Behr
authors.forename: Valérie
authors.initials: V
authors.lastname: Chetboul
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Pouchelon
authors.forename: Maud
authors.initials: M
authors.lastname: Castaignet
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Gouni
authors.forename: Charlotte
authors.initials: C
authors.lastname: Misbach
authors.forename: Amandine M P
authors.initials: AM
authors.lastname: Petit
authors.forename: Nicolas
authors.initials: N
authors.lastname: Borenstein
mesh_terms: D000818:Animals; D001145:Arrhythmias, Cardiac / Q000188:drug therapy / Q000662:veterinary; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000662:veterinary*; D002317:Cardiovascular Agents / Q000627:therapeutic use; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D004452:Echocardiography / Q000379:methods / Q000662:veterinary*; D005260:Female; D008946:Mitral Valve Stenosis / Q000601:surgery / Q000662:veterinary*
chemical_list: D002317:Cardiovascular Agents