Application of the Alfieri technique for the resolution of tricuspid dysplasia in 7 canines
Main Article Content
Abstract
The application of the Alfieri technique in humans is a well-known and pioneering thechnique that was replaced by modern atrioventricular valve repair strategies.1,2 This technique in canines and also in humans is yet a valid alternative, particullary to canine tricuspid dysplasia.1 The “strategy” consists to transform the “monorificial” dysplastic tricuspid valve insufficiency into a “biorificial” one by means of a suturing at the level of the valve apposition face in the site of greatest regurgitant flow. The surgical field is cleared from blood by means of occlusion of both venae cavae. With this strategy the reduction of the insufficiency jet was achieved in 7 canine carriers of said congenital pathology. The technique demonstrated its anatomical reliability, repeatability, low mortality, and low cost. Of the total number of cases operated on, one patient died the day after surgery, another patient a year later due to non-cardiac causes, and the rest continue under clinical follow-up at the time of presenting this series.
Article Details
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
2. De Bonis M, Lapenna E, Alfieri O. Edge-to-edge Alfieri technique for mitral valve repair: which indications? Curr Opin Cardiol. 2013 Mar;28(2):152-7. doi: 10.1097/HCO.0b013e32835b9256. PMID: 23147777.
3. Chetboul V, Poissonnier C, Bomassi E, Jamin C, Pouchelon JL, Tissier R, Desquilbet L. Epidemiological, clinical, and echocardiographic features, and outcome of dogs with Ebstein's anomaly: 32 cases (2002-2016). J Vet Cardiol. 2020 Jun;29:11-21. doi: 10.1016/j.jvc.2020.03.003. Epub 2020 Apr 3. PMID: 32348933.
4. Famula TR, Siemens LM, Davidson AP, Packard M. Evaluation of the genetic basis of tricuspid valve dysplasia in Labrador Retrievers. Am J Vet Res. 2002 Jun;63(6):816-20. doi: 10.2460/ajvr.2002.63.816. PMID: 12061526.
5. de Madron E, Kadish A, Spear JF, Knight DH. Incessant atrial tachycardias in a dog with tricuspid dysplasia. Clinical management and electrophysiology. J Vet Intern Med. 1987 Oct-Dec;1(4):163-9. doi: 10.1111/j.1939-1676.1987.tb02010.x. PMID: 3506101.
6. Navarro-Cubas X, Palermo V, French A, Sanchis-Mora S, Culshaw G. Tricuspid valve dysplasia: A retrospective study of clinical features and outcome in dogs in the UK. Open Vet J. 2017;7(4):349-359. doi: 10.4314/ovj.v7i4.11. Epub 2017 Dec 9. PMID: 29296595; PMCID: PMC5738889.
7. Pasławska, Urszula, Noszczyk-Nowak, Agnieszka, Janiszewski, Adrian and Nicpoń, Józef. & Tricuspid Dysplasia in Dogs" Journal of Veterinary Research, vol.57, no.1, 2013, pp.123- 126. https://doi.org/10.2478/bvip-2013-0023
8. Tricuspid valve dysplasia in dogs. S. Favril, B.J.G. Broeckx , H. de Rooster, P. Smets, L. Peelman, C. Bavegems. DOI : 10.21825/vdt.v87i1.16091
9. Andelfinger G, Wright KN, Lee HS, et al. Canine tricuspid valve malformation, a model of human Ebstein anomaly, maps to dog chromosome 9. J Me d Genet 2003;40:320–4.
10. Liu SK, Tilley LP. Dysplasia of the tricuspid valve in the dog and cat. J Am Vet Med Assoc 1976;169:623–30.
11. Chetboul V, Tran D, Carlos C, et al. Congenital malformations of the tricuspid valve in domestic carnivores: a retrospective study of 50 cases. Schweiz Arch Tierheilkd 2004;146:265–75.
12. Hoffmann G, Amberger CN, Seiler G, Lombard CW. Tricuspid valve dysplasia in fifteen dogs. Schweiz Arch Tierheilkd 2000;142:268–77.
13. Belluschi I, Buzzatti N, Castiglioni A, Alfieri O, De Bonis M. The Alfieri’s edge-to-edge technique for mitral valve repair: from a historical milestone of cardiac surgery to the origin of the transcatheter era. Mini-invasive Surg 2020;4:58. http://dx.doi.org/10.20517/2574-1225.2020.48
14. Sutherland BJ, Pierce KV, Heffner GG, Scansen BA, Miller MW, Grey P, Orton EC. Surgical repair for canine tricuspid valve dysplasia: Technique and case report. J Vet Cardiol. 2021 Feb;33:34-42. doi: 10.1016/j.jvc.2020.11.001. Epub 2020 Nov 10. PMID: 33279771.
15. Chul Park, Chi-Bong Choi, Jung-Hyang Sur1, Byung-Hyun Chung,and Hee-Myung Park. Tricuspid valve dysplasia(TVD) in an American cocker spaniel dog. Korea J Vet Res(2004) 44(1) : 125~129
16. Stephen, J. Ettinger and Edward, C. Feldman, In: Textbook of Veterinary Internal Medicine. pp. 795-796, 5th ed. Saunders, Philadelphia, 2000, 137.
17. Philip, R. Fox, David Sisson and N. Sydney Moïse, In: Textbook of Canine and Feline Cardiology. pp. 524525, 2nd ed. Saunders, Philadelphia, 1999.
18. June, A. Boon. In: Manual of Veterinary echocardiography. pp. 424-431, 1st ed. Lippincott, Baltimore, 1998.
19. Mark D. Kittleson DVM PhD, Richard D. Kienle DVM. Small Animal Cardiovascular Medicine. Chapter 17, Congenital Abnormalities of the Atrioventricular Valves, Tricuspid Valve Dysplasia.
20. Afecciones cardiovasculares en pequeños animales, 2ed. Belerenian, G. Mucha, C.J., Camacho, A.A., Manubens Grau, J. Ed Intermedica, 2007.
21. Actualización en cardiología Veterinaria Tomo 1. Ed Intermedica. 2023. Guillermo Belerenian, Cristian Daniel Rodriguez.
22. Cirugía cardíaca en animales de compañía: Técnicas con el corazón latiendo. Editorial Académica Española (2017). Guillermo Belerenian, Cristian Daniel Rodriguez.
23. Ottavio Alfieri, Francesco Maisano, Michele De Bonis, Pier Luigi Stefano, Lucia Torracca, Michele Oppizzi, Giovanni La Canna. The double-orifice technique in mitral valve repair: A simple solution for complex problems, The Journal of Thoracic and Cardiovascular Surgery, Volume 122, Issue 4, 2001, Pages 674-681, ISSN 0022-5223, https://doi.org/10.1067/mtc.2001.117277.