New technique for intrathoracic implantation of extraluminal spiral prostheses in the trachea

Background: Extraluminal surgical procedures for intrathoracic tracheal collapse in dogs are not routinely performed. The patients are normally treated with different drugs or by intraluminal stents. However, in more severe cases, drug treatment does not always have good outcomes, and intraluminal prostheses can be correlated to several postoperative problems. In order to obtain better results, we aimed to develop a surgical technique for implantation of a new extraluminal helical prosthesis in the thoracic segment of the trachea through cervical access, associated with pneumatic mediastinoscopy for certification of the technique and minimization of possible complications. Materials, Methods & Results: Seven canine corpses (CCs) from non-traumatic death, weighing between 2 and 7 kg, were used. A ventral cervical approach to the trachea was associated with blunt mediastinal dissection. Trans cervical pneumatic mediastinoscopy was used for evaluation of the dissection and location of the implant. These were compared with the necropsy findings by the exact Wilcoxon two-sample test, with P < 0.05. The results of necropsy and mediastinoscopy did not present significant differences at P < 0.05. During the examinations, the presence of some mediastinal visceral le-sions caused by the prosthesis, the integrity of the mediastinum and possible lesions to RLN and blood vessels (BV) were analyzed. We also investigated the location of the distal part of the prosthesis in the thoracic segment of the trachea and its dissection. To evaluate the technique, statistical comparison was made between mediastinoscopy and necropsy find-ings. The data were compared by the Wilcoxon test at 5% probability. The tracheas of all CCs were efficiently dissected, but in some cases problems that can happen during the procedure were noticed. This was checked by mediastinoscopy and confirmed by necropsy. The median of the scores was...(AU)

New technique for intrathoracic implantation of extraluminal spiral prostheses in the trachea

Background: Extraluminal surgical procedures for intrathoracic tracheal collapse in dogs are not routinely performed. The patients are normally treated with different drugs or by intraluminal stents. However, in more severe cases, drug treatment does not always have good outcomes, and intraluminal prostheses can be correlated to several postoperative problems. In order to obtain better results, we aimed to develop a surgical technique for implantation of a new extraluminal helical prosthesis in the thoracic segment of the trachea through cervical access, associated with pneumatic mediastinoscopy for certification of the technique and minimization of possible complications. Materials, Methods & Results: Seven canine corpses (CCs) from non-traumatic death, weighing between 2 and 7 kg, were used. A ventral cervical approach to the trachea was associated with blunt mediastinal dissection. Trans cervical pneumatic mediastinoscopy was used for evaluation of the dissection and location of the implant. These were compared with the necropsy findings by the exact Wilcoxon two-sample test, with P < 0.05. The results of necropsy and mediastinoscopy did not present significant differences at P < 0.05. During the examinations, the presence of some mediastinal visceral le-sions caused by the prosthesis, the integrity of the mediastinum and possible lesions to RLN and blood vessels (BV) were analyzed. We also investigated the location of the distal part of the prosthesis in the thoracic segment of the trachea and its dissection. To evaluate the technique, statistical comparison was made between mediastinoscopy and necropsy find-ings. The data were compared by the Wilcoxon test at 5% probability. The tracheas of all CCs were efficiently dissected, but in some cases problems that can happen during the procedure were noticed. This was checked by mediastinoscopy and confirmed by necropsy. The median of the scores was...

Monitorização eletrocardiográfica contínua em cães portadores de degeneração mixomatosa valvular mitral / Continuous electrocardiographic monitoring in dogs with mitral valve mixomatic degeneration

A Degeneração Mixomatosa Valvar (DMV) representa um processo degenerativo crônico dos folhetos atrioventriculares, impedindo sua perfeita coaptação. Consequentemente podem ocorrem a ativação de mecanismos compensatórios congestivos e o início de uma importante sintomatologia. Em muitos casos esta enfermidade correlaciona-se com a ocorrência de importantes arritmias. Neste trabalho descrevem-se sob os aspectos clínicos e arritmogênicos, por meio do método Holter, de dois casos de DMV em pacientes de diferentes classificações funcional, segundo os critérios do Colégio Americano de Medicina Veterinária Interna, um em estágio B1 e outro em estágio D crônico. Os achados apontam que as arritmias cardíacas são eventos recorrentes em pacientes portadores de Degeneração Mixomatosa Valvar Mitral (DMVM), e que ainda em estágios iniciais, sem remodelamento, esta pode estar presente em baixa densidade; bem como nos estágios avançados, o índice de remodelamento cardíaco pode estar diretamente correlacionado à incidência de arritmias, comumente descritas na literatura, ou outras mais graves não relatadas, como a disfunção sinusal.

Myxomatous Valve Degeneration (DMV) represents a chronic degenerative process of the atrioventricular leaflets, preventing their perfect coaptation. Consequently, the activation of congestive compensatory mechanisms and the beginning of an important symptomatology may occur. In many cases this disease is correlated with the occurrence of important arrhythmias. In this work, two clinical cases of DMV in patients with different functional classification according to the American College of Internal Veterinary Medicine criteria are described under clinical and arrhythmogenic aspects, one in stage B1 and the other in chronic stage D. The findings indicate that cardiac arrhythmias are recurrent events in patients with Myxomatous Mitral Valve Degeneration (DMVM), and that even in the early stages without remodeling, they may be present in low density; as well as in the advanced stages, the cardiac remodeling index it may be directly correlated with the incidence of arrhythmias commonly described in the literature, or other more serious ones not reported, such as sinus dysfunction.

Monitorização eletrocardiográfica contínua em cães portadores de degeneração mixomatosa valvular mitral / Continuous electrocardiographic monitoring in dogs with mitral valve mixomatic degeneration

A Degeneração Mixomatosa Valvar (DMV) representa um processo degenerativo crônico dos folhetos atrioventriculares, impedindo sua perfeita coaptação. Consequentemente podem ocorrem a ativação de mecanismos compensatórios congestivos e o início de uma importante sintomatologia. Em muitos casos esta enfermidade correlaciona-se com a ocorrência de importantes arritmias. Neste trabalho descrevem-se sob os aspectos clínicos e arritmogênicos, por meio do método Holter, de dois casos de DMV em pacientes de diferentes classificações funcional, segundo os critérios do Colégio Americano de Medicina Veterinária Interna, um em estágio B1 e outro em estágio D crônico. Os achados apontam que as arritmias cardíacas são eventos recorrentes em pacientes portadores de Degeneração Mixomatosa Valvar Mitral (DMVM), e que ainda em estágios iniciais, sem remodelamento, esta pode estar presente em baixa densidade; bem como nos estágios avançados, o índice de remodelamento cardíaco pode estar diretamente correlacionado à incidência de arritmias, comumente descritas na literatura, ou outras mais graves não relatadas, como a disfunção sinusal.(AU)

Myxomatous Valve Degeneration (DMV) represents a chronic degenerative process of the atrioventricular leaflets, preventing their perfect coaptation. Consequently, the activation of congestive compensatory mechanisms and the beginning of an important symptomatology may occur. In many cases this disease is correlated with the occurrence of important arrhythmias. In this work, two clinical cases of DMV in patients with different functional classification according to the American College of Internal Veterinary Medicine criteria are described under clinical and arrhythmogenic aspects, one in stage B1 and the other in chronic stage D. The findings indicate that cardiac arrhythmias are recurrent events in patients with Myxomatous Mitral Valve Degeneration (DMVM), and that even in the early stages without remodeling, they may be present in low density; as well as in the advanced stages, the cardiac remodeling index it may be directly correlated with the incidence of arrhythmias commonly described in the literature, or other more serious ones not reported, such as sinus dysfunction.(AU)

Videothermometry to evaluate metabolic activity in real time during pneumectomy in rats.

PURPOSE: To evaluate, in rats, the open field videothermometry in real time while performing left pneumonectomy for early diagnosis of cardiopulmonary changes. METHODS: Twelve non-specific pathogen-free Wistar rats were randomly allocated into two groups; pneumectomy group (GP) and sham surgery group (GS). Mean arterial pressure, videothermometry in real time, of the right lung, and histopathological analysis of the remaining lung were evaluated in all animals. RESULTS: Videothermometry in real time allowed identification of temperature variance of right lung after pneumectomy, indicating a significant decrease in temperature during evaluation. There was a statistical difference between M0 and M1, M1 and M2 and M0 and M2 (p<0.004) in GS, and significant difference between M0 and M1, M1 and M2, and M2 and M0 with p<0.0001 in GP. CONCLUSIONS: Left pneumonectomy in rats shows initial histopathological changes after 60 minutes of its completion, indicating a possible compensation beginning. The open-field videothermometry in real time proved to be efficient identifying the temperature changes of the remaining lung.

Videothermometry to evaluate metabolic activity in real time during pneumectomy in rats

Purpose:To evaluate, in rats, the open field videothermometry in real time while performing left pneumonectomy for early diagnosis of cardiopulmonary changes.Methods:Twelve non-specific pathogen-free Wistar rats were randomly allocated into two groups; pneumectomy group (GP) and sham surgery group (GS). Mean arterial pressure, videothermometry in real time, of the right lung, and histopathological analysis of the remaining lung were evaluated in all animals.Results:Videothermometry in real time allowed identification of temperature variance of right lung after pneumectomy, indicating a significant decrease in temperature during evaluation. There was a statistical difference between M0 and M1, M1 and M2 and M0 and M2 (p<0.004) in GS, and significant difference between M0 and M1, M1 and M2, and M2 and M0 with p<0.0001 in GP.Conclusions:Left pneumonectomy in rats shows initial histopathological changes after 60 minutes of its completion, indicating a possible compensation beginning. The open-field videothermometry in real time proved to be efficient identifying the temperature changes of the remaining lung.(AU)

Videothermometry to evaluate metabolic activity in real time during pneumectomy in rats

Abstract Purpose: To evaluate, in rats, the open field videothermometry in real time while performing left pneumonectomy for early diagnosis of cardiopulmonary changes. Methods: Twelve non-specific pathogen-free Wistar rats were randomly allocated into two groups; pneumectomy group (GP) and sham surgery group (GS). Mean arterial pressure, videothermometry in real time, of the right lung, and histopathological analysis of the remaining lung were evaluated in all animals. Results: Videothermometry in real time allowed identification of temperature variance of right lung after pneumectomy, indicating a significant decrease in temperature during evaluation. There was a statistical difference between M0 and M1, M1 and M2 and M0 and M2 (p<0.004) in GS, and significant difference between M0 and M1, M1 and M2, and M2 and M0 with p<0.0001 in GP. Conclusions: Left pneumonectomy in rats shows initial histopathological changes after 60 minutes of its completion, indicating a possible compensation beginning. The open-field videothermometry in real time proved to be efficient identifying the temperature changes of the remaining lung.

Use of total venous inflow occlusion to enable correction of an atrial septal defect in a dog

Background: Atrial septal defects are generally classified into three types: ostium secundum, ostium primum, and sinus venosus. Diagnose is normaly confirmed with Doppler echocardiography, which can identify and classify atrial septal defects types. This cardiac anomaly may be corrected by different surgical approaches, such as cardiopulmonary bypass or transvenous approaches. Therefore, we chose to close the atrial septal defect using a total venous inflow occlusion technique (TIVO), which has been successfully used in other procedures without major postoperative complications, and are notably cheaper and requires no specialized equipment, been able to be done in different places.Case: An American Pit Bull Terrier was referred to our surgical service for ostium secundum atrial septal defect correction, by the time of surgery the patient presented dyspneic; normal capillary refill time and rectal temperature; the owner mentioned the patient exhibited exercise intolerance and delayed development compared to other dogs of the same age or from the same litter. Cardiac auscultation revealed a systolic murmur at the left base, femoral pulse was normokinetic, and patient was emaciated and prostrated at the time of clinical evaluation. Atrial septal defect was suspected and then confirmed by Doppler echocardiography that revealed a discontinuous area in the interatrial septum, and by color doppler images an aliased signal, that extended through the interatrial septum and shunted from the left to the right atria, was visualized, confirming an ostium secundum atrial septal defect. After a right intercostal thoracotomy, a subphrenic pericardiectomy was performed to provide access to the heart. Cranial and caudal vena cava as well as the azygos vein, were dissected, which allowed placement of a Satinskys clamp to proceed with TIVO. Before TIVO initiation, a pursestring suture with 3-0 polypropylene was applied to the right atrium.[...](AU)

Infrared video thermometry guidance for surgical correction of chylothorax in dogs

Background: Macroscopic identification of the extravasation site of chyle in patients with chylothorax is a major challenge. Current forms of identification are invasive and/or expose patients to radiation, as in computerized tomography and radiography. A prototype device that uses infrared video thermometry images to detect temperature increments of 0.1ºC has been developed. This device can process and show real-time images or video on a monitor during surgeries. Therefore, the aim of this work was to report the first successful case in which this innovative device was tested in the transoperative period to identify the thoracic duct and its tributaries in a chylothorax surgery performed in a dog.Case: A 2-year-old male dog of the Shiba Inu breed was presented to the veterinary hospital with exercise intolerance, cough, emaciation, and no history of trauma. Clinical examination was performed along with complete blood count, biochemical analysis, and thoracic radiography. The patient exhibited dyspnea and had diminished breath sounds on chest auscultation. Radiographic images revealed moderate pleural effusion. The dog was anesthetized and submitted to thoracotomy, which enabled visualization of a chylous effusion. A sample of the effusion was collected for cytological and biochemical analyses. Subsequently, pericardiectomy was carried out, and identification of the thoracic duct and its tributaries was guided by an innovative device that generates infrared video thermometry images in real time. The extravasation site of the chyle was visualized on the images shown on a monitor. Consequently, after ligation of the tributary vessel, interruption of chyle overflow could be noticed on the monitor. Thoracotomy was routinely closed, and a drain was placed through an intercostal space after incision. Thirty days after the surgery, the dog exhibited no signs of recurrence.[...]

Use of total venous inflow occlusion to enable correction of an atrial septal defect in a dog

Background: Atrial septal defects are generally classified into three types: ostium secundum, ostium primum, and sinus venosus. Diagnose is normaly confirmed with Doppler echocardiography, which can identify and classify atrial septal defects types. This cardiac anomaly may be corrected by different surgical approaches, such as cardiopulmonary bypass or transvenous approaches. Therefore, we chose to close the atrial septal defect using a total venous inflow occlusion technique (TIVO), which has been successfully used in other procedures without major postoperative complications, and are notably cheaper and requires no specialized equipment, been able to be done in different places.Case: An American Pit Bull Terrier was referred to our surgical service for ostium secundum atrial septal defect correction, by the time of surgery the patient presented dyspneic; normal capillary refill time and rectal temperature; the owner mentioned the patient exhibited exercise intolerance and delayed development compared to other dogs of the same age or from the same litter. Cardiac auscultation revealed a systolic murmur at the left base, femoral pulse was normokinetic, and patient was emaciated and prostrated at the time of clinical evaluation. Atrial septal defect was suspected and then confirmed by Doppler echocardiography that revealed a discontinuous area in the interatrial septum, and by color doppler images an aliased signal, that extended through the interatrial septum and shunted from the left to the right atria, was visualized, confirming an ostium secundum atrial septal defect. After a right intercostal thoracotomy, a subphrenic pericardiectomy was performed to provide access to the heart. Cranial and caudal vena cava as well as the azygos vein, were dissected, which allowed placement of a Satinsky’s clamp to proceed with TIVO. Before TIVO initiation, a pursestring suture with 3-0 polypropylene was applied to the right atrium.[...]

Infrared video thermometry guidance for surgical correction of chylothorax in dogs

Background: Macroscopic identification of the extravasation site of chyle in patients with chylothorax is a major challenge. Current forms of identification are invasive and/or expose patients to radiation, as in computerized tomography and radiography. A prototype device that uses infrared video thermometry images to detect temperature increments of 0.1ºC has been developed. This device can process and show real-time images or video on a monitor during surgeries. Therefore, the aim of this work was to report the first successful case in which this innovative device was tested in the transoperative period to identify the thoracic duct and its tributaries in a chylothorax surgery performed in a dog.Case: A 2-year-old male dog of the Shiba Inu breed was presented to the veterinary hospital with exercise intolerance, cough, emaciation, and no history of trauma. Clinical examination was performed along with complete blood count, biochemical analysis, and thoracic radiography. The patient exhibited dyspnea and had diminished breath sounds on chest auscultation. Radiographic images revealed moderate pleural effusion. The dog was anesthetized and submitted to thoracotomy, which enabled visualization of a chylous effusion. A sample of the effusion was collected for cytological and biochemical analyses. Subsequently, pericardiectomy was carried out, and identification of the thoracic duct and its tributaries was guided by an innovative device that generates infrared video thermometry images in real time. The extravasation site of the chyle was visualized on the images shown on a monitor. Consequently, after ligation of the tributary vessel, interruption of chyle overflow could be noticed on the monitor. Thoracotomy was routinely closed, and a drain was placed through an intercostal space after incision. Thirty days after the surgery, the dog exhibited no signs of recurrence.[...](AU)