Abstract
Observations
A 9 year-old, 40 kg, female spayed Bouvier des Flandres was anesthetized for surgical
removal of an intra-cardiac mass. Pre-anesthetic work-up included thoracic radiographs,
which revealed moderate pleural effusion, and cardiac ultrasound, which identified
a mass attached to the wall of the right ventricular outflow tract (RVOT). The mass
caused dynamic obstruction of the RVOT during systole. The dog was pre-medicated with
intravenous (IV) hydromorphone (0.05 mg kg−1). Following pre-oxygenation, anesthesia was induced with ketamine (3.75 mg kg−1, IV) and diazepam (0.18 mg kg−1, IV). Anesthesia was maintained with isoflurane in oxygen, an intravenous constant
rate infusion (CRI) of fentanyl (10–30 μg kg−1 hour−1) and a CRI of lidocaine (50–200 μg kg−1 minute−1). A right lateral thoracotomy was performed. The heart was stopped transiently with
a cold cardioplegic solution for 7.83 minutes to allow the removal of the mass through
an open-heart procedure. No cardiopulmonary bypass was used. The heart was successfully
restarted after cardiopulmonary resuscitation with internal cardiac massage and internal
defibrillation. The dog recovered uneventfully from anesthesia without any apparent
neurological sequelae. Post-operative analgesia consisted of intercostal nerve blocks
with bupivacaine, CRIs of fentanyl (2–5 μg kg−1 hour−1) and lidocaine (40 μg kg−1 minute−1) and with oral meloxicam (0.1 mg kg−1). Five days following surgery, the dog was discharged from the hospital. Histopathology
and immunohistochemistry of the mass identified an ectopic thyroid carcinoma.
Conclusions
This case showed the feasibility of whole body hypothermia and using a cold cardioplegic
solution to induce cardiac arrest for a short open-heart procedure.
Keywords
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References
- Surgical correction of a partial atrioventricular septal defect with a ventricular septal defect in a dog.J Am Anim Hosp Assoc. 2005; 41: 137-143
- Primary and secondary heart tumours in dogs and cats.J Comp Pathol. 2007; 136: 18-26
- Cardiovascular and respiratory effects of ketamine infusions in isoflurane-anesthetized dogs before and during noxious stimulation.Am J Vet Res. 2005; 66: 2122-2129
- Right ventricular outflow obstruction caused by primary cardiac neoplasia. Clinical features in two dogs.Vet Intern Med. 1990; 4: 12-16
- Inclusion of lidocaine in cardioplegic solutions provides additional myocardial protection.J Cardiovasc Surg (Torino). 2004; 45: 551-555
- Pericardial effusion in a dog with rhabdomyosarcoma in the right ventricular wall.J Small Anim Pract. 1996; 37: 193-196
- Evaluation of techniques and outcomes of mitral valve repair in dogs.J Am Vet Med Assoc. 2004; 224: 1941-1945
- Does lower systemic temperature enhance cardioplegic myocardial protection?.J Thorac Cardiovasc Surg. 1981; 81: 11-20
- Cardiovascular disease.in: Tranquilli WJ Thurmon JC Grimm KA Lumb and Jones’ Veterinary anesthesia and analgesia. 4th edn. Blackwell Publishing, IA, USA2007: 891-897
- Cardiovascular changes in dogs given diazepam and diazepam-ketamine.Am J Vet Res. 1986; 47: 795-798
- Surgical correction of subvalvular aortic stenosis using cardiopulmonary bypass in a dog.J Vet Med Sci. 2004; 66: 559-562
- Total venous inflow occlusion in the normothermic dog: a study of haemodynamic, metabolic and neurological consequences.Res Vet Sci. 1992; 52: 371-377
- Myocardial protection by anesthetic agents against ischemia-reperfusion injury: an update for anesthesiologists.Can J Anesth. 2002; 49: 777-791
- Resection of subvalvular aortic stenosis. Surgical and perioperative management in seven dogs.Vet Surg. 1993; 22: 419-430
- In vivo electrophysiological effects of lidocaine in canine acute myocardial infarction.Circ Res. 1975; 36: 84-91
- Central venous pressure, pulmonary artery occlusion pressure, intrathoracic blood volume, and right ventricular end-diastolic volume as indicators of cardiac preload.J Crit Care. 1996; 11: 180-188
- Evaluation of induction by use of a combination of oxymorphone and diazepam or hydromorphone and diazepam and maintenance of anesthesia by use of isoflurane in dogs with experimentally induced hypovolemia.Am J Vet Res. 2005; 66: 1227-1237
- Diagnosis and surgical repair of partial atrioventricular septal defects in two dogs.J Am Vet Med Assoc. 1997; 211: 569-572
- Surface-induced hypothermia in dogs: 19 cases (1987–1989).J Am Vet Med Assoc. 1993; 202: 437-444
- The anesthetic potency of fentanyl in terms of its reduction of enflurane MAC.Anesthesiology. 1982; 57: 485-488
- A case report of surgical treatment of a dog with atrioventricular septal defect (incomplete form of endocardial cushion defect).J Vet Med Sci. 1994; 56: 981-984
- Mild hypothermia during prolonged cardiopulmonary cerebral resuscitation increases conscious survival in dogs.Crit Care Med. 2004; 32: 2110-2116
- Plasma concentrations and cardiovascular influence of lidocaine infusions during isoflurane anesthesia in healthy dogs and dogs with subaortic stenosis.Vet Surg. 1998; 27: 486-497
- Anesthesia for cardiac surgery procedures.in: Miller RD Miller’s Anesthesia. 6th edn. Elsevier, PA, USA2005: 1941-2004
- An open patch-graft technique for correction of pulmonic stenosis in the dog.Vet Surg. 1990; 19: 148-154
- Open surgical repair of tetralogy of Fallot in dogs.J Am Vet Med Assoc. 2001; 219: 1089-1093
- Technique and outcome of mitral valve replacement in dogs.J Am Vet Med Assoc. 2005; 226: 1508-1511
- Uses of hypothermia in cardiovascular surgery.in: Ream AK Fogdall RP Acute Cardiovascular Management. JB Lippincott Co, PA, USA1982: 830-851
- Grading of patients for surgical procedures.Anesthesiology. 1941; 2: 281-284
- Hypothermia-induced cardioprotection using extended ischemia and early reperfusion cooling.Am J Physiol: Heart Circ Physiol. 2007; 292: H1995-H2003
- Anesthesia for cardiac surgery.in: Barash PG Cullen BF Stoelting RK Clinical Anesthesia. 5th edn. Lippincott Williams and Wilkins, Philadelphia, PA, USA2006: 886-932
- Effect of intravenous administration of ketamine on the minimum alveolar concentration of isoflurane in anesthetized dogs.Am J Vet Res. 2006; 67: 21-25
- Volatile anesthetic-induced cardiac preconditioning.J Anesth. 2007; 21: 212-219
- Nonbarbiturate intravenous anesthetic drugs.in: Stoelting RK Hillier SC Pharmacology and Physiology in Anesthetic Practice. 4th edn. Lippincott Williams and Wilkins, Philadelphia. PA, USA2006: 155-178
- Inflammatory response and cardioprotection during open-heart surgery: the importance of anaesthetics.Br J Pharmacol. 2007; 153: 21-33
- Effect of lidocaine on the minimum alveolar concentration of isoflurane in dogs.Vet Anaesth Analg. 2004; 31: 264-271
- Monitoring adequacy of ventilation by capnometry during thoracotomy in dogs.J Am Vet Med Assoc. 1998; 212: 377-379
- Systemic, metastatic, eu- and heterotope tumours of the heart in necropsied dogs.Zentralbl Veterinarmed A. 1996; 43: 31-45
- Cardiac tumors in dogs: 1982–1995.J Vet Intern Med. 1999; 13: 95-103
- Congestive heart failure caused by intracardiac tumours in two dogs.J Small Anim Pract. 2006; 47: 480-483
- Assessment of fluid responsiveness in mechanically ventilated cardiac surgical patients.Eur J Anaesthesiol. 2005; 22: 658-665
Article info
Publication history
Accepted:
May 16,
2008
Received:
March 27,
2008
Identification
Copyright
© 2009 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Inc. All rights reserved.
