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Resection of Subvalvular Aortic Stenosis Surgical and Perioperative Management in Seven Dogs
Author(s) -
KOMTEBEDDE JAN,
ILKIW JAN E.,
FOLLETTE DAVID M.,
BREZNOCK EUGENE M.,
TOBIAS ANTHONY H.
Publication year - 1993
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/j.1532-950x.1993.tb00417.x
Subject(s) - medicine , perioperative , resection , stenosis , cardiology , surgery
Open heart surgery was performed during cardiopulmonary bypass (CPB) to surgically correct subvalvular aortic stenosis in seven dogs. After initiation of total CPB, cardiac arrest was induced by antegrade and retrograde administration of blood cardioplegia. The subvalvular fibrous stenosis was resected through a transverse aortotomy. Intraoperatively and postop‐eratively, dobutamine, nitroprusside, lidocaine, blood(‐products), and crystalloid solutions were used to manage hypotension and optimize cardiac index. Aortic cross‐clamp time varied from 73 to 166 minutes, and duration of CPB varied from 130 to 210 minutes, latrogenic incision into the mitral valve in two dogs was the most significant introperative complication. Postoperative complications included: hypoproteinemia (n = 7), premature ventricular depolarization (n = 6), increased systemic vascular resistance index (n = 5), increased O 2 extraction (n = 3), pulmonary edema (n = 2), and decreased cardiac index (n = 1). All seven dogs were discharged alive and in stable condition. Six dogs are alive and in stable condition after a mean follow up of 15.8 months. This is the first detailed report of CPB in a series of clinical veterinary patients. Using the techniques described in this paper, open heart surgery of considerable duration can be performed successfully in dogs with significant myocardial hypertrophy and endomyocardial fibrosis secondary to subvalvular aortic stenosis.