Heterotopic implantation of a porcine bioprosthetic heart valve in a dog with aortic valve endocarditis

CASE DESCRIPTION: A 5-year-old male German Shepherd Dog was evaluated because of a 5-month history of progressive lethargy, weight loss, and heart failure. CLINICAL FINDINGS: On physical examination, bounding femoral pulses and systolic and diastolic murmurs were detected. Echocardiography revealed severe aortic valve insufficiency (AVI) and a large vegetative lesion on the aortic valve consistent with aortic valve endocarditis. The AVI velocity profile half-time was 130 milliseconds; the calculated peak systolic pressure gradient across the aortic valve was 64 mm Hg. Left ventricular diameter during diastole was 63.6 mm (predicted range, 40.2 to 42 mm) and during systole was 42.9 mm (predicted range, 25.4 to 27 mm). Systolic, diastolic, and mean arterial blood pressures were 120, 43, and 65 mm Hg, respectively. TREATMENT AND OUTCOME: To palliate severe AVI, the descending aorta was occluded (duration, 16.75 minutes) and heterotopic implantation of a porcine bioprosthetic heart valve in that vessel was performed. After surgery, systolic, diastolic, and mean arterial blood pressures were 115, 30, and 61 mm Hg, respectively, in the forelimb and 110, 62, and 77 mm Hg, respectively, in the hind limb. Within 6 months, the AVI velocity profile half-time had increased to 210 milliseconds, indicating diminished severity of AVI. After 24 months, the dog was able to engage in vigorous exercise; no pulmonary edema had developed since surgery. CLINICAL RELEVANCE: Heterotopic bioprosthetic heart valve implantation into the descending aorta during brief aortic occlusion appears feasible in dogs and may provide substantial palliation for dogs with severe AVI.     

Short-term performance of mitral valve replacement with porcine bioprosthetic valves in dogs

Porcine bioprosthetic valves cross-linked with glutaraldehyde and polyepoxy compound were newly developed for mitral valve replacement (MVR) in dogs. Five beagle dogs were performed a left thoracotomy and underwent MVR using the porcine bioprosthetic valves during cardiopulmonary bypass (CPB). A vein catheter inserted into right atrium and a vent catheter inserted into the right ventricle to drain. The hemodynamic conditions of CPB were excellent during surgery. The left atrial pressure was measured before and after MVR; there was no significant difference and it was normal. Thrombosis and the prosthetic valve regurgitation were not observed one week after MVR. Pressure half time (PHT) prolonged significantly (P<0.05) from 31.40 +/- 4.0 msec presurgery to 99.20 +/- 19.4 msec at seven days after MVR, although it indicated the normal range as the bioprosthetic valve. The symptom of the prosthetic valve failure was not observed. This study indicated that the MVR using porcine bioprosthetic valves under CPB might have been effective in dogs as a short-term evaluation.     

Long-term clinical evaluation of mitral valve replacement with porcine bioprosthetic valves in dogs

This study evaluated the long-term clinical performance of newly developed porcine bioprosthetic valves cross-linked with glutaraldehyde and polyepoxy compound for mitral valve replacement (MVR) in dogs. Five beagle dogs underwent MVR using the porcine bioprosthetic valves during cardiopulmonary bypass. Antithrombotic drugs were administered only for one month after MVR. Six months after MVR, transvalvular regurgitation was not observed in all dogs, paravalvular leakage was seen only in one dog. Twelve months after MVR, mild transvalvular regurgitations were observed in two dogs. Although diastolic atrioventricular pressure gradient was increased gradually, no significant differences were observed. Pressure half-time and valve area were within normal ranges as the bioprosthetic value. There was no clinical symptom of the thrombosis and the thrombogenesis was not observed in the porcine bioprosthetic valve and the annulus in all dogs for twelve months after MVR. The clinical findings suggest that antithrombogenicity of the valves were maintained, though the duability might not be enough in the long-term period.     

The heart remembers: observations of cardiac memory in the Dorper sheep heart

Memory is a property common to a diverse range of tissues. Cardiac memory has been demonstrated in the human, dog, rat and rabbit. This is a peculiar phenomenon, reflected in the T wave of the electrocardiogram. The heart is able to remember periods of alterations in the sequence of ventricular activation and once there is a return to a normal sequence of ventricular activation the T waves may manifest memory. Cardiac memory is noted when the T wave during normal ventricular activation retains the vector of the previous abnormal QRS complex, caused by a period of altered ventricular activation. Possible mechanisms of memory in the heart are alterations of the transient outward potassium current (I10) in ventricular myocytes and new protein synthesis inside myocytes. These two mechanisms operate in short- and long-term cardiac memory respectively. Currently, it is unknown whether memory may have adverse structural consequences in the heart. We were able to demonstrate memory in the hearts of Dorper wethers and this is the first report of cardiac memory in Dorper sheep.     

A survey by questionnaire of parasitic worm control in cattle and sheep at the Glasgow University Lanark practice

The results of a questionnaire circulated in 1984 concerning parasitic worm control on cattle and sheep farms in a veterinary practice in the west of Scotland are reported. Control by grazing management or anthelmintic treatment was used in 92 per cent of the cattle herds and in all the sheep flocks. The use of anthelmintic drugs was greatest on farms where grazing control was also practised. Benzimidazoles were the most frequently used anthelmintic drugs.     

Electrocardiographic surrogates of structural myocardial alterations in the Dorper sheep heart

In this study we evaluated the validity of well-known human electrocardiographic markers of myocardial pathology in Dorper sheep. These markers include: the duration of the QRS complex of premature ventricular complexes (PVCs), the presence of notching of the QRS complex of PVCs and change of the ST-segment of PVCs. It was shown that these three electrocardiographic phenomena correlate with myocardial pathology in the hearts of Dorper sheep. We also describe a new electrocardiographic indicator of myocardial pathology, namely an increase in the frequency of cardiac memory T waves as a new electrocardiographic surrogate for myocardial pathology in the hearts of Dorper sheep.     

Role of the serotonin transporter in heart valve development and disease

Veterinary Research Communications -     

Aldosterone plasma concentration in horses with heart valve insufficiencies

In humans and small animals, heart disease can lead to an increase in aldosterone, and the aldosterone level correlates with the severity of the heart disease. In horses similar interactions may be possible and may lead to an increase in aldosterone in horses with heart valve insufficiencies. In a prospective clinical trial eight healthy horses (control group) and 40 horses with heart valve disease were examined. In all horses, a clinical (auscultation), electro- and echocardiographic examination was performed and aldosterone plasma concentration was determined. The median aldosterone plasma concentration in the control group was 23.95 pg/ml. Twenty-one out of 40 horses with heart valve insufficiencies and without dimensional changes by echocardiography (group 1) showed a median aldosterone plasma concentration of 45.5 pg/ml. Five out of the 40 horses had a left atrial (LA) dilation and an average LA size with 147.6+/-11 mm (group 2) and a median aldosterone plasma concentration of 95.9 pg/ml. Five other horses had a left ventricular (LV) dilation with an average LV size of 141.6+/-6.8 mm (group 3) and a median aldosterone plasma concentration of about 115.3 pg/ml. In this group a positive correlation between aldosterone plasma concentration and LV existed (r=0.9, P=0.03). Nine horses with both LA (152.8+/-11.4 mm) and LV dilatation (145+/-9 mm, group 4) had a median aldosterone plasma concentration of 161.2 pg/ml. Significant differences of the aldosterone concentrations were observed between the control group and the horses with LA and LV dilation (group 4, P=0.0005), as well as between group 1 (horses with heart valve insufficiency but without dilation) and group 4 (P=0.0006). The study confirms that, as reported for other species, aldosterone rises as the severity of valvular disease increases. However, in this study, as there is only significant difference from normal in the most affected group, it will require further study before the plasma aldosterone level can be relied on as an indicator of the severity of heart disease in an individual horse.     

Ventricular dyssynchrony as a cause of structural disease in the heart of Dorper sheep

Ventricular dyssynchrony is a disturbance of the normal, organized electromechanical coupling of the two ventricles. This condition has many causes, such as left bundle branch block, ventricular preexcitation, right ventricular pacing and right ventricular premature ventricular complexes (PVCs). Ventricular dyssynchrony has many adverse haemodynamic effects on the left ventricle and we wanted to know whether these adverse haemodynamic effects might have any structural consequences on the left ventricles of such hearts. Six healthy Dorper wethers were subjected to numerous right ventricular PVCs to induce ventricular dyssynchrony in order to determine whether any structural consequences will occur in the left ventricles of these hearts. Myocarditis in the musculature of the left ventricles of all six these hearts was seen.     

Observations on the effect of age on the severity of heart valve lesions in the dog

Chronic valvular disease (valvular endocardiosis) is the most common cardiac abnormality of the dog. This paper demonstrates how this condition increases in frequency and severity with advancing age by means of a visual impression method for the gross examination of the heart valves. These lesions occur in descending order of frequency and severity in the left atrioventricular valve, the septal cusp of the right atrioventricular valve, the mural cusp of the same valve, the aortic valve and the pulmonary valve. The histopathological features of these lesions are outlined. Résumé. La maladie chronique valvulaire (endocardiose valvulaire) est l'anomalie la plu commune chez le chien. Cette étude démontre comment la fréquence et la sévérité de cett condition s'accroissent avec l'âge par moyens de méthode d'impression visuelle pour l'examer en gros des valves du c?ur. Ces lésions se produisent en order diminuant de fréquence et do sévérité dans la valve atrioventriculaire gauche, dans la cuspide septale de la valve atrioventri culaire droite, la cuspide murale de la même valve, la valve de l'aorte et la valve pulmonaire On souligne les caractéristiques histopathologiques de ces lésions. Zusammenfassung. Chronische valvuläre Erkrankung (valvuläre Endocardiosis) ist die gewöhnlichtste Herzabnormalität in Hunden. Diese Zeitschrift legt dar wir, mittels visuellem Eindrucksverfahrens für die allgemeine Untersuchung der Herzklappen, sich diese Kondition an Häufigkeit und Schwere mit zunehmendem Alter steigert. Diese Läsionen treten in abfallender Ordnung an Häufigkeit und Schwere in der linken Herzvorhof-Kammerklappe, der Cuspis septalis der rechten Herzvorhof-Kammerklappe, der Cuspis muralis von derselben Klappe, der aortischen Klappe und der pulmonalen Klappe. Die histopathologischen Merkmale von diesen Läsionen sind umrissen.     

Comparative macroanatomic investigations of the venous drainage of the heart in Akkaraman sheep and Angora goats

This study was carried out to evaluate the origin, course and terminations of the cardiac veins in Akkaraman sheep and Angora goats. These vessels are the great cardiac, left marginal, middle cardiac, right cardiac and smallest cardiac veins. For this purpose, latex was injected into the jugular vein of eight adult healthy Akkaraman sheep and Angora goats. These veins were dissected. It has been shown that the middle cardiac vein and great cardiac veins coursed with the branches of the coronary arteries and that they were anastomosed with each other. The venous blood from the great cardiac vein and middle cardiac veins emptied into the right atria via the coronary sinus. The venous blood from the interventricular septum was conveyed to the middle cardiac vein and great cardiac veins.     

Congestive heart failure associated with myxomatous degeneration of the left atrioventricular valve in a parakeet

Congestive heart failure was diagnosed in a 27-year-old Indian ringneck parakeet with exercise-induced dyspnea. A grade IV/VI holosystolic murmur that radiated to the right sternal area was auscultated over the left side of the sternum. Radiography revealed progressive cardiomegaly, hepatomegaly, pulmonary edema, and accumulation of fluid within the coelomic cavity. Echocardiography revealed biatrial enlargement and enlargement of the right ventricle. Doppler recording revealed high velocity left and right atrioventricular valve regurgitation. Treatment with digoxin and furosemide alleviated clinical signs for approximately 10 months. Gross postmortem examination revealed cardiac enlargement and eccentric hypertrophy of both ventricles on cross-section. Pulmonary congestion and edema, hepatomegaly, hepatic congestion, and ascites were also evident. Histologic examination of the heart revealed myxomatous degeneration of the left atrioventricular valve, muscular hypertrophy of the right atrioventricular valve, and biventricular chronic myofiber degeneration and necrosis.     

Haemobartonella felis infection in cats from the Glasgow area

A survey of 155 cats for Haemobartonella felis infection in the Glasgow area revealed a prevalence of 23.2 per cent. The infection occurred in all age groups and there was no significant difference between sex or breed type. Infection with H felis was more prevalent among cats with fleas and those with feline leukaemia virus infection than among the other cats in the sample. H felis organisms identified were mainly coccoid with diameters between 0.63 micron and 1.73 micron. Rod forms, found in two cats, had lengths ranging from 0.79 micron to 1.1 micron and diameters between 0.17 micron and 0.24 micron.     

Beating heart mitral valve replacement with a bovine pericardial bioprosthesis for treatment of mitral valve dysplasia in a Bull Terrier

OBJECTIVES: To describe an open, beating heart surgical technique and use of a bovine pericardial prosthetic valve for mitral valve replacement (MVR) in the dog. STUDY DESIGN: Clinical case report. ANIMALS: Male Bull Terrier (17-month-old, 26 kg) with mitral valve dysplasia and severe regurgitation. METHODS: A bovine pericardial bioprosthesis was used to replace the mitral valve using an open beating heart surgical technique and cardiopulmonary bypass. RESULTS: Successful MVR was achieved using a beating heart technique. Mitral regurgitation resolved and cardiac performances improved (left ventricular end-diastolic diameter decreased from 57.6 to 48.7 mm, and left atrium/aorta ratio returned to almost normal, from 1.62 to 1.19). Cardiopulmonary by-pass time and total surgical duration were decreased compared with standard cardioplegic techniques. Surgical recovery was uneventful and on echocardiography 6 months later valve function was excellent. CONCLUSION: Considering the technique advantages (no cardiac arrest, ischemic reperfusion injury, and hypothermia, or the need for aortic dissection and cannulation for administration of cardioplegic solution), short-term mortality and morbidity may be reduced compared with standard cardioplegic techniques. CLINICAL RELEVANCE: Based on experience in this dog, beating heart mitral valvular replacement is a seemingly safe and viable option for the dog and bovine pericardial prosthesis may provide better long-term survival than mechanical prostheses.     

Plasma atrial natriuretic peptide concentration in warmblood horses with heart valve regurgitations

ObjectivesThis study measured plasma atrial natriuretic peptide (ANP) concentration in horses with heart valve regurgitations (HVR) with and without atrial and ventricular dilatation.BackgroundIn humans and small animals, plasma ANP concentration is increased in heart disease and correlates with the severity of clinical signs and heart enlargement.Animals, materials and methodsTen healthy horses (control) and 36 horses with HVR were evaluated by auscultation, electrocardiography, echocardiography, and determination of plasma ANP.ResultsControl horses demonstrated mean plasma ANP concentration of 21 ± 5.4 pg/mL. Of the 36 horses with HVR, 17 horses possessed normal echocardiographic heart size (group 1), 10 horses had a left atrial dilatation (group 2) and 9 horses had both left atrial and ventricular dilatation (group 3). Mean plasma ANP concentration of groups 1, 2 and 3 was 20.1 ± 5.6 pg/mL, 22.9 ± 11.0 pg/mL and 27.6 ± 17.4 pg/mL, respectively. The plasma ANP concentrations of HVR and control horses were not significantly different. The highest ANP concentrations were observed in horses with atrial and ventricular dilatation. No correlation between left atrial or ventricular size, weight, or sex and the plasma ANP concentration was found.ConclusionsNo significant differences in plasma ANP concentration was observed between groups. Further study, especially in horses with clinical signs of heart failure is needed.     

Echocardiographic detection of pulmonic valve rupture in a horse with right-sided heart failure

Pulmonic valve rupture was determined to be the cause of severe right-sided heart failure in a 20-year-old Thoroughbred gelding. A flail in the intermediate pulmonic valve cusp was detected by 2-dimensional echocardiography. Significant pulmonic and tricuspid valvular regurgitation were confirmed by Doppler echocardiography. Despite treatment, the horse's condition deteriorated, and euthanasia was performed. At necropsy, a tear in the pulmonary artery extending into the right valve cusp and a tear at the base of the intermediate valve cusp were identified at the junction of the right and intermediate pulmonic valve cusps. Careful echocardiographic evaluation of the pulmonic valve is warranted for horses with right-sided heart failure, for which more common causes cannot be found.