Cardiology JASMINE Veterinary Cardiovascular Medical Center Yokohama, Kanagawa, Japan
Abstract:
Background: Mitral valve repair (MVR) is a potential curative treatment for myxomatous mitral valve disease (MMVD) in dogs. Pulmonary hypertension (PH) commonly accompanies MMVD, yet its prognostic impact on MVR outcomes is unclear. Hypothesis/
Objectives: To assess MVR outcomes in dogs with severe PH and provide insights for MVR candidacy. Animals: We retrospectively analyzed MMVD dogs with severe PH that underwent MVR at our institute from February 2017 to December 2020. Severe PH was diagnosed based on the ACVIM consensus and defined as tricuspid valve regurgitant pressure gradient (TRPG) above 75 mmHg.
Methods: Over a 3-6 year postoperative follow-up, patients were categorized into two groups: those who developed PH post-surgery (PH group), and those who did not (non-PH group). Echocardiographic values and clinical course were evaluated based on medical records.
Results: Seventeen dogs were included (non-PH: n = 9, PH: n = 8). There is no difference between non-PH and PH in preoperative TRPG (83 [79–95] vs. 85 [83–89] mmHg, P = 0.888). One month after surgery, TRPG was significantly higher in the PH group (27 [23–47] vs. 59 [44–71] mmHg, P = 0.02). Both groups showed significant TRPG reduction after surgery (P < 0.01, P < 0.01). The median time to develop right congestive heart failure (n = 6) was 441 days [101–1084] post-surgery. Conclusions and Clinical Importance: Postoperative TRPG reductions are achievable by MVR in dogs with severe PH. The data suggest that MVR can be a viable option to manage MMVD in dogs with concomitant severe PH.
