Case Report: Emergency mitral valve plasty in an unstable dog with left atrial rupture secondary to myxomatous mitral valve disease
Abstract
Objective: To describe the medical and surgical management of recurrent left atrial rupture (LAR) in a dog with severe mitral regurgitation (MR). This report focuses on challenges encountered with pericardiocentesis, the role of hemodynamic support, and the importance of invasive blood pressure monitoring.
Case summary: An 11-year-old, weighing 2.9 kg, male Chihuahua was scheduled for mitral valve plasty due to severe MR. The dog developed acute collapse and dyspnea and was diagnosed with LAR and pulmonary edema; pericardiocentesis was withheld due to relatively stable hemodynamics. Despite inotropic support and diuretics administration, a second LAR occurred the following day during transport for echocardiographic examination, with a large intrapericardial clot preventing pericardiocentesis and causing shock. Although fluid therapy and ephedrine administration improved blood pressure, invasive blood pressure monitoring and strict rest were subsequently employed to maintain a lower systolic pressure, enabling safe anesthetic induction. Under cardiopulmonary bypass, clot removal was performed. Intraoperatively, due to inadequate venous return, the heart enlarged and a third LAR occurred, necessitating repair of the rupture site with a pericardial patch under cardioplegic arrest alongside chordae tendineae reconstruction. Postoperatively, the dog developed dyspnea potentially related to lung injury, transfusion effects, or residual pulmonary edema, which resolved with medical…
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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