Clinical Outcomes of Mitral Valve Repair in Dogs With Pulmonary Hypertension Secondary to Myxomatous Mitral Valve Disease

ABSTRACT Background Myxomatous mitral valve disease (MMVD) can cause pulmonary hypertension (PH). Mitral valve repair (MVR) has been described as a surgical treatment option for MMVD, but the benefit of MVR when PH is present is unknown. Hypothesis/Objectives To investigate the change in echocardiog...

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Main Authors: Tomohiko Yoshida, Darcy Adin, Katsuhiro Matsuura
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:Journal of Veterinary Internal Medicine
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Online Access:https://doi.org/10.1111/jvim.70106
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author Tomohiko Yoshida
Darcy Adin
Katsuhiro Matsuura
author_facet Tomohiko Yoshida
Darcy Adin
Katsuhiro Matsuura
author_sort Tomohiko Yoshida
collection DOAJ
description ABSTRACT Background Myxomatous mitral valve disease (MMVD) can cause pulmonary hypertension (PH). Mitral valve repair (MVR) has been described as a surgical treatment option for MMVD, but the benefit of MVR when PH is present is unknown. Hypothesis/Objectives To investigate the change in echocardiographic variables and long‐term outcomes of dogs with PH secondary to MMVD after MVR. Animals Twenty‐one dogs with PH secondary to MMVD that underwent MVR. Methods Inclusion criteria were MMVD dogs that had a high probability of PH according to the metrics established in the American College of Veterinary Internal Medicine (ACVIM) consensus statement on PH in dogs, and that had two follow‐up evaluations. Echocardiographic variables before MVR were compared with the follow‐up evaluations after surgery. Results Before surgery, 12 dogs were Stage C whereas 9 dogs were Stage D. Echocardiographically normalized left ventricular internal diameter in diastole (LVIDDN), mitral E wave velocity, the ratio of the left atrial dimension to the aortic annulus dimension (LA/Ao) and tricuspid regurgitation velocity were significantly decreased after surgery (p < 0.01). Complete resolution of preoperative clinical signs was achieved in 71.4% of dogs after surgery. However, two dogs had residual PH (9.5%) and three dogs that had resolution of PH post‐operatively had recurrent PH (14.2%). Conclusions and Clinical Importance We showed that most dogs with PH before MVR had decreases in estimated pulmonary arterial pressure after surgery as well as resolution of clinical signs. Some dogs had residual PH and late PH recurrence after MVR, which could suggest underlying pulmonary arterial pathology.
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spelling doaj-art-d4c4440966894e8f8f05b4b78ae50b9b2025-08-20T03:54:11ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762025-05-01393n/an/a10.1111/jvim.70106Clinical Outcomes of Mitral Valve Repair in Dogs With Pulmonary Hypertension Secondary to Myxomatous Mitral Valve DiseaseTomohiko Yoshida0Darcy Adin1Katsuhiro Matsuura2Department of Clinical Veterinary Medicine Obihiro University of Agriculture and Veterinary Medicine Obihiro JapanDepartment of Small Animal Clinical Sciences College of Veterinary Medicine University of Florida Gainesville Florida USADepartment of Small Animal Clinical Sciences College of Veterinary Medicine University of Florida Gainesville Florida USAABSTRACT Background Myxomatous mitral valve disease (MMVD) can cause pulmonary hypertension (PH). Mitral valve repair (MVR) has been described as a surgical treatment option for MMVD, but the benefit of MVR when PH is present is unknown. Hypothesis/Objectives To investigate the change in echocardiographic variables and long‐term outcomes of dogs with PH secondary to MMVD after MVR. Animals Twenty‐one dogs with PH secondary to MMVD that underwent MVR. Methods Inclusion criteria were MMVD dogs that had a high probability of PH according to the metrics established in the American College of Veterinary Internal Medicine (ACVIM) consensus statement on PH in dogs, and that had two follow‐up evaluations. Echocardiographic variables before MVR were compared with the follow‐up evaluations after surgery. Results Before surgery, 12 dogs were Stage C whereas 9 dogs were Stage D. Echocardiographically normalized left ventricular internal diameter in diastole (LVIDDN), mitral E wave velocity, the ratio of the left atrial dimension to the aortic annulus dimension (LA/Ao) and tricuspid regurgitation velocity were significantly decreased after surgery (p < 0.01). Complete resolution of preoperative clinical signs was achieved in 71.4% of dogs after surgery. However, two dogs had residual PH (9.5%) and three dogs that had resolution of PH post‐operatively had recurrent PH (14.2%). Conclusions and Clinical Importance We showed that most dogs with PH before MVR had decreases in estimated pulmonary arterial pressure after surgery as well as resolution of clinical signs. Some dogs had residual PH and late PH recurrence after MVR, which could suggest underlying pulmonary arterial pathology.https://doi.org/10.1111/jvim.70106caninecardiac surgeryechocardiographyleft‐sided heart diseaseprognosis
spellingShingle Tomohiko Yoshida
Darcy Adin
Katsuhiro Matsuura
Clinical Outcomes of Mitral Valve Repair in Dogs With Pulmonary Hypertension Secondary to Myxomatous Mitral Valve Disease
Journal of Veterinary Internal Medicine
canine
cardiac surgery
echocardiography
left‐sided heart disease
prognosis
title Clinical Outcomes of Mitral Valve Repair in Dogs With Pulmonary Hypertension Secondary to Myxomatous Mitral Valve Disease
title_full Clinical Outcomes of Mitral Valve Repair in Dogs With Pulmonary Hypertension Secondary to Myxomatous Mitral Valve Disease
title_fullStr Clinical Outcomes of Mitral Valve Repair in Dogs With Pulmonary Hypertension Secondary to Myxomatous Mitral Valve Disease
title_full_unstemmed Clinical Outcomes of Mitral Valve Repair in Dogs With Pulmonary Hypertension Secondary to Myxomatous Mitral Valve Disease
title_short Clinical Outcomes of Mitral Valve Repair in Dogs With Pulmonary Hypertension Secondary to Myxomatous Mitral Valve Disease
title_sort clinical outcomes of mitral valve repair in dogs with pulmonary hypertension secondary to myxomatous mitral valve disease
topic canine
cardiac surgery
echocardiography
left‐sided heart disease
prognosis
url https://doi.org/10.1111/jvim.70106
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AT katsuhiromatsuura clinicaloutcomesofmitralvalverepairindogswithpulmonaryhypertensionsecondarytomyxomatousmitralvalvedisease