Our Summary

This study looked at sixteen cases where dogs developed a serious heart rhythm disorder, known as ventricular fibrillation (VF), during a surgery to remove part of the sac around the heart (a pericardiectomy). The dogs underwent surgery for various reasons such as a type of fluid build-up in the chest (idiopathic chylothorax), cancer, an unknown cause of fluid around the heart (idiopathic pericardial effusion) and an immune response to foreign bodies (foreign body granuloma). Different surgical methods were used, and in most cases, electrosurgical devices, which use electrical energy to cut or coagulate tissue, were used. It appears that VF often happened when these devices were in use. However, it also occurred in some cases where it wasn’t clear that these devices were the cause. Many of the dogs had heart rhythm problems before developing VF. Sadly, most of the dogs died from VF during the surgery. The study concludes that VF is a major risk during this type of surgery, and it might be connected to the use of electrosurgical devices and the way the heart is handled during the operation. However, more research is needed to confirm this. Surgeons need to be aware of this risk, particularly when operating on dogs with existing heart rhythm problems. They may need to be more cautious in using electrosurgical devices during these surgeries.

FAQs

  1. What is ventricular fibrillation and how did it occur during pericardiectomy in dogs?
  2. What are some of the reasons why dogs might undergo a pericardiectomy?
  3. How might the use of electrosurgical devices in pericardiectomy be linked to the occurrence of ventricular fibrillation?

Doctor’s Tip

One helpful tip a doctor might give a patient undergoing a pericardiectomy is to be aware of the potential risk of developing a serious heart rhythm disorder during the surgery. It is important for the patient to inform their surgeon of any existing heart rhythm problems and for the surgeon to take extra precautions, such as minimizing the use of electrosurgical devices, to reduce the risk of complications. Patients should also follow post-operative care instructions carefully and attend follow-up appointments to monitor their recovery and heart health.

Suitable For

Pericardiectomy is typically recommended for patients with conditions such as idiopathic chylothorax, cancer, idiopathic pericardial effusion, and foreign body granuloma. However, patients with existing heart rhythm problems may be at a higher risk of developing complications, such as ventricular fibrillation, during the surgery. Surgeons need to be cautious when using electrosurgical devices and handling the heart during the operation in these cases. More research is needed to fully understand the risks associated with pericardiectomy in patients with pre-existing heart rhythm problems.

Timeline

Before pericardiectomy:

  1. Patient presents with symptoms such as chest pain, shortness of breath, and fatigue.
  2. Diagnostic tests are performed, such as echocardiogram and MRI, to confirm the diagnosis of constrictive pericarditis.
  3. Treatment options, including medications and pericardiocentesis, are considered before deciding on surgery.
  4. Patient undergoes pre-operative evaluation to assess their overall health and risk factors for surgery.

After pericardiectomy:

  1. Surgery is performed to remove part of the pericardial sac surrounding the heart.
  2. Patient is closely monitored in the intensive care unit post-operatively for any complications such as bleeding or infection.
  3. Patient may experience pain and discomfort in the chest post-surgery.
  4. Patient undergoes cardiac rehabilitation to improve heart function and overall recovery.
  5. Follow-up appointments and monitoring are scheduled to assess the success of the surgery and overall heart health.

What to Ask Your Doctor

  1. What is the purpose of a pericardiectomy surgery?
  2. What are the potential risks and complications associated with pericardiectomy surgery?
  3. How will my heart rhythm be monitored during the surgery?
  4. Are electrosurgical devices commonly used during pericardiectomy surgery?
  5. What measures will be taken to reduce the risk of developing ventricular fibrillation during the surgery?
  6. How experienced is the surgical team in performing pericardiectomy surgeries?
  7. What is the expected recovery time and outcome after a pericardiectomy surgery?
  8. Are there any alternative treatment options to consider?
  9. What can I do to help minimize the risk of complications during and after the surgery?
  10. Are there any specific instructions or precautions I should follow post-surgery to promote healing and prevent complications?

Reference

Authors: Raleigh JS, Mayhew PD, Visser LC, Milovancev M, Kuntz CA, Formaggini L, Chiu HC, Skinner OT, Naiman JH, Oblak ML, McAnulty JF, Hoffman CL, Brückner M, Singh A. Journal: Vet Surg. 2022 May;51(4):611-619. doi: 10.1111/vsu.13795. Epub 2022 Mar 7. PMID: 35257394