Mitral Valve Repair Surgery

Jump to Degenerative Mitral Valve Disease and FAQs.

 

The University of Florida Veterinary Hospital has partnered with Dr. Uechi and his team from the Jasmine Clinic in Japan to provide mitral valve repair surgery in Florida.  Medical treatment for degenerative mitral valve disease can delay the onset of heart failure using pimobendan and control the signs of heart failure such as breathlessness once it develops.  However, the average survival time once heart failure develops is nine months even with medical management.

Dr. Uechi and his team have greater than 90% success rate using cardiopulmonary bypass to stop the heart beating and allow the valve to be repaired.  Surgical repair includes replacing the broken or stretched chordae tendineae (“heart strings”) and reducing the size of the mitral valve.

***UPDATE*** Our plan is to complete the first surgeries during 2020 with the team visiting every two months and performing up to six cases each time.  Dogs will be selected based on health status with close collaboration with the team from Japan.  Dogs with a history of heart failure (stage C) will be prioritized but dogs with enlarged hearts before heart failure also will be considered (stage B2).

Requirements prior to surgery:

To be considered for the waiting list please email the following to  OpenHeart@vetmed.ufl.edu

  • Patient medical records
  • Echocardiographic examination and report (cardiac ultrasound) by a boarded cardiologist
  • Chest radiographs

Prior to scheduling surgery date:

  • Abdominal ultrasound
  • Blood type determination (DEA 1.1 status)

Two to three months before surgery date:

  • Urinalysis including USG (urine specific gravity) and UPC (urine protein to creatinine ratio)
  • Blood tests including:
    • CBC (Complete blood count)
    • Complete biochemistry profile including electrolytes
    • Total T4, Free T4 and TSH test if indicated, (thyroid evaluation)
    • SDMA (biomarker for kidney function)
    • One to two months prior to surgery date:
      • Coagulation profile: ATIII (antithrombin), PT (prothrombin time) and APTT (partial thromboplastin time)
      • C reactive protein (indicator of systemic inflammation)
  • Other tests that may be required depending on other results or findings:
    • Spec cPL (indicator of pancreatitis)
    • 4DX snap test (lyme, ehrlichia, anaplasmosis, heartworm test)
    • ACTH stimulation test or low dose dexamethasone test (evaluates adrenal function)
    • Urine culture
    • Fecal testing
    • Biopsy of lumps or masses if present

Surgical appointment

Patients will arrive two to three days prior to surgery for pre-operative assessment.  Following the surgery, the patient is closely and continuously monitored by our Emergency and Critical Care team for the first 48 hours followed by decreasing levels of supervision as required.  Patients should be discharged from five to seven days post operatively barring complications.  Drugs to prevent clots developing should be administered for the first three to six months.  Ongoing cardiac medications will be recommended on a case by case basis.

Follow-up

This can be at the University of Florida or with your local cardiologist.  An echocardiogram is recommended one month postoperatively, then every three months for the first year.  Beyond that, appointments every six months are suggested.