Our Summary

This research paper is about a study that was conducted to test a new method of performing a certain type of heart surgery in dogs. The surgery, called a pericardiectomy, is usually performed on dogs that have a recurring condition where too much fluid collects around their heart. The new method they tested involves going through the diaphragm, a muscle that sits below the heart and helps with breathing.

The study involved 40 dead dogs, half of which were small (weighing less than 10 kg) and half of which were large (weighing more than 20 kg). They split each size group in half again, using the new method on one half and the traditional method (going between the ribs) on the other. They then compared the success of the surgeries by looking at how much of the pericardium (the sac around the heart) they were able to remove. They found that the new method was just as effective as the old one for small dogs, but less so for large dogs.

The researchers also used the new method on nine living dogs that belonged to clients and needed the surgery. They found that there were no complications during the surgeries, and none of the dogs had a recurrence of their condition afterwards. This led them to conclude that the new method is straightforward and safe for both small and large dogs.

FAQs

  1. What is a pericardiectomy and when is it indicated?
  2. How does the transdiaphragmatic approach to pericardiectomy compare to the intercostal approach in terms of resected pericardium percentage?
  3. Were there any complications or recurrence of pericardial effusion observed in the clinical patients that underwent a transdiaphragmatic pericardiectomy?

Doctor’s Tip

A doctor might tell a patient that a transdiaphragmatic approach for pericardiectomy is a safe and effective surgical procedure to obtain permanent pericardial drainage in both small and large breed dogs. This approach provides excellent exposure of the pericardium and associated phrenic nerves, and has been shown to have low rates of intraoperative complications and recurrence of pericardial effusion in clinical patients. It is important for patients to follow post-operative care instructions and attend follow-up appointments to ensure a successful recovery.

Suitable For

Patients who are typically recommended pericardiectomy are those with recurrent pericardial effusions. This procedure is indicated for dogs with pericardial effusion that is causing clinical signs or recurrent in nature. Pericardiectomy may be recommended when medical management of pericardial effusion is ineffective or when the effusion recurs despite medical treatment. The transdiaphragmatic approach for subtotal pericardiectomy in dogs has been shown to be a feasible and safe surgical procedure for obtaining permanent pericardial drainage in both small and large breed dogs.

Timeline

Before pericardiectomy:

  • Patient presents with recurrent pericardial effusions
  • Patient undergoes diagnostic testing such as imaging studies to confirm the presence of pericardial effusion
  • Treatment options such as pericardiocentesis may be attempted to temporarily relieve symptoms
  • If pericardiocentesis is not effective or if effusions recur, pericardiectomy may be recommended

After pericardiectomy:

  • Patient undergoes subtotal pericardiectomy via a transdiaphragmatic approach
  • Surgery is successful in resecting a portion of the pericardium to allow for permanent drainage
  • Patient is monitored postoperatively for any complications
  • In clinical patients, no intraoperative complications are encountered and no recurrence of pericardial effusion is seen
  • Patient experiences relief from symptoms associated with recurrent pericardial effusions

What to Ask Your Doctor

  1. What is the purpose of a pericardiectomy?
  2. Why is a pericardiectomy recommended for me?
  3. What are the potential risks and complications associated with a pericardiectomy?
  4. What is the expected outcome of the surgery?
  5. How long is the recovery period after a pericardiectomy?
  6. Will I need any follow-up appointments or additional treatment after the surgery?
  7. Are there any lifestyle changes or restrictions I should be aware of post-surgery?
  8. How experienced are you in performing pericardiectomies?
  9. Are there any alternative treatments or procedures available for my condition?
  10. Can you provide me with more information on the transdiaphragmatic approach specifically?

Reference

Authors: De Ridder M, Kitshoff A, Devriendt N, Or M, Rubio-Guzman A, de Rooster H. Journal: Vet Rec. 2017 Jan 28;180(4):95. doi: 10.1136/vr.103962. Epub 2016 Nov 23. PMID: 27881694