• Journal of Veterinary Clinics
• /
• v.33 no.6
• /
• pp.368-371
• /
• 2016

A four month-old intact female Maltese (weighing 1.8 kg) was present with major complaints of severe coughing and dyspnea. Diagnostic imaging studies revealed abnormally elongated chordae tendineae attached to anterior leaflet and shortened chordae tendineae attached to posterior leaflet of mitral valve causing mitral insufficiency and regurgitant blood flow into left atrium, indicating congenital mitral valve dysplasia. Therapy was directed to control existing clinical signs and to prevent further deterioration of cardiac enlargement using conventional cardiac medications. The dog is currently survived and being monitored at regular interval. This is the first case report describing mitral valve dysplasia causing mitral insufficiency of dog in Korea.

• Journal of Veterinary Clinics
• /
• v.18 no.3
• /
• pp.273-278
• /
• 2001

Chronic mitral valvular insufficiency (CMVI) is the most common heart disease in dogs. The prevalence of CMVI is age-dependent. CMVI is usually affected to small to medium size breeds. It is more prevalent in males than females. The characteristic lesions of CMVI are caused by an acquired chronic structural degeneration of the mitral valve defined as endocardiosis or myxomatous degeneration. The main clinical signs are cough, respiratory distress, weakness and pleural effusion and ascites by secondary right-sided heart failure. The most prominent clinical finding is a systolic heart murmur. The thoracic radiography and echocardiography are useful methods in diagnosis of CMVI. Thoracic radiographic findings are left atrial enlargement, left main stem bronchial compression and pulmonary edema. Echocardiography is confirmed to increased left atrial and ventricular dimension, mitral regurgitation, mitral valve thickening and abnormal movement. Thoracic radiography and echocardiography are used to obtain a definite diagnosis of CMVI, and then to study the progression of the condition.

• Journal of Chest Surgery
• /
• v.7 no.2
• /
• pp.189-200
• /
• 1974

The mitral valve replacement with Beall prosthetic valve was performed on three patients, and double valve replacement. aortic and mitral valve, was performed in this department.1) The preoperative studies about the first case were compatible with mitral steno-insufficency.The diseased mitral valve was replaced with the medium sized Beall prosthetic valve under the cardiopulmonary hypass using hypothermic hemodilution technique. The total perfusion time was eighty minutes. Immediate postoperative course was smooth, but this patient was died of asphyxia due to tracheomalacia complicated after tracheostomy 3 months after operation. Autopsy on this patient revealed that no thrombus and no ball variance could be found, and endothelization on the valve cuff was satisfactory. 2) The preoperative studies on the second case were compatible with mitral insufficiency. The diseased mitral valve was replaced with the medium sized Beall prosthetic valve under the cardiopulmonary bypass using hypothermic hemodilution technigue. The total perfusion time was 123 minutes. This patient was discharged in good condition and follow-up study after 16 months revealed the patient had enjoyed healthy life. 3) The preoperative studies about the third case were compatible with aortic insufficiency and mitral stenoinsufficiency. The diseased valves were replaced with type 2 sutureless Magovern aortic valve and the medium sized Beall mitral prosthesis under cardiopulmonary bypass using hypothermic hemodilution technIque and coronary artery perfusion. The total perfusion time was 155 minutes. This patient was discharged in good condition, but thromboembolism was developed 2 months after discharge. 4) The preoperative studies about the fourth case were compatible with mitral insufficiency. The diseased mitral valve was replaced with the medium sized Beall prosthetic valve. The total perfusion time was 132 minutes. The atrioventricular block developed just after operation but converted to normal sinus rhythmn on the third postperative day. The preoperative NYHA functional classification IV was converted to Class 1 or 11 at the time of discharge and this patient enjoyed healthy life. Attendum; The fifth case, nineteen years old male with mital insufficiency underwent Beall valve replacement and his course was uneventful 2 weeks after operation.

• Journal of Chest Surgery
• /
• v.2 no.1
• /
• pp.77-84
• /
• 1969

Retrograde left cardioangiographic studies using Amplatz spring coil guide catheter were carried out in 30 cases of acquired mitral valvular diseases. Of these 12 cases were compatible with the clinical diagnosis which were made pre-angiocardiographically. Eighteen out of 30 cases were diagnosed as pure mitral stenosis or mitral insufficiency which had been clinically diagnosed as mitral stenoinsufficiency or mitral stenosis with aortic insufficiency. The rate of difference is 60%. Twenty-five cases or 83% of all cases were operated. Of these 6 cases, the degree of regurgitation through the mitral valves were able to be evaluated cardioangiography and were confirmed by open heart operation. The retrograde left cardioangiography is considered to be a useful tool in conclusive dianosis of clinically equivocal mitral valvular diseases.

• Korean Journal of Veterinary Service
• /
• v.45 no.1
• /
• pp.55-61
• /
• 2022

In veterinary medicine, a variety of disease are known to cause coagulation abnormalities. Identification of these coagulation abnormalities have been relied on traditional coagulation assays(platelet concentration, aPTT, PT, D-dimer, fibrinogen) which take only a small part of the coagulation pathways rather than global hemostatic capacity. Among of the hypercoagulable diseases, cardiovascular disease, such as mitral valvular disease, was not regarded as the cause of the hypercoagulability. The value of a thromboelastography (TEG) as an early predictor of coagulopathy, especially hypercoagulability, has been founded. It was associated with decreased R and K values, and increased MA and α angle. The objective of this study was to compare thromboelastography results and those of traditional coagulation tests between twenty adult dogs with mitral insufficiency (MVI group) and eleven adult healthy dogs (Healthy group). As a results, MA values in the patients with mitral insufficiency (68.8±7.8 mm) were significantly higher than the normal patients (60.4±4.8 mm) (P value<0.05). Although a little report has been reported in veterinary medicine, platelet activation seems to be related with hypercoagulability in MVI patients in human medicine. The result of this report can support this pathophysiology in veterinary medicine. In addition to traditional coagulation assay, global assessment of coagulopathy using TEG, especially ability to detect hypercoagulability, may be useful for customized treatment in MVI patients. To achieve this, further study is needed to define pathophysiology and effect of medication.

• Journal of Chest Surgery
• /
• v.13 no.2
• /
• pp.100-104
• /
• 1980

Simultaneous triple valve replacements were performed in two patients on January and April 1980 at Seoul National University Hospital. The first case was 17 years old male patient with a history of exertional dyspnea for 7 years. He was in class III by the NYHA functional classification and diagnosed as aortic insufficiency, mitral steno-insufficiency and tricuspid insufficiency. The second case was 46 years old male patient suffered from exertional dyspnea for 5 years, He was in class IV and diagnosed as aortic stenoinsufficiency, mitral stenoinsufficiency and tricuspid insufficiency. Triple valve replacements were performed under the deep hypothermia and pharmacologic cardiac arrest with aortic cross clamping for 80 minutes to 159 minutes. Total extracorporeal circulation time were 197 and 176 minutes respectively. The postoperative courses were uneventful.

• Proceedings of the Korean Society of Veterinary Clinics Conference
• /
• 2008.05a
• /
• pp.74-74
• /
• 2008

• Journal of Chest Surgery
• /
• v.13 no.4
• /
• pp.405-413
• /
• 1980

A total of 63 patients [42 males and 21 females] underwent multiple valve replacement with artificial valves between January 1975 and August 1980 at Seoul National University Hospital. There were 38 patients with aortic and mitral valve replacement, 22 with mitral and tricuspid, and 3 with aortic, mitral and tricuspid valve replacement. The valve lesions varied from trivial to severe and most aortic and mitral valves had mixed stenosis and insufficiency, while tricuspid valves had only insufficiency. The patients were severely symptomatic in majority of the cases, and belonged to the Classes III and IV [III:45, IV:16] of the NYHA functional criteria. Hemodynamic studies were performed on all the patients. The mean pulmonary wedge pressure was remarkably increased to 19.8 mmHg in aortic and mitral valve lesions and 18.0 mmHg in mitral and tricuspid valve lesions. The mean pulmonary arterial pressure was also increased, while the cardiac index was reduced. In 1977, the average perfusion time was 245.5 minutes for aortic and mitral valve replacement and 181.6 minutes for mitral and tricuspid valve replacement. It has progressively declined to 169.2 minutes for aortic and mitral valve replacement and 123 minutes for mitral and tricuspid valve replacement in 1980. The average period of aortic occlusion also declined after the use of cardioplegic solution. Twenty deaths occurred among the 63 patients operated upon, an overall mortality rate of 30.8%. The operative mortality has declined with successive year from a level of 66.7% before 1977 to 21.1% in 1980. Fourteen patients suffered from a list of postoperative complications, which eventually resolved with adequate treatment. All the survivors were enjoying the levels of daily life activities greater than those existing before the operation.

• Journal of Chest Surgery
• /
• v.16 no.4
• /
• pp.526-532
• /
• 1983

This is a report of one case of Loffler`s eosinophilic endocarditis associated with mitral insufficiency and LV thrombi treated surgically at the department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital. This patient was a 42 year old female and she has complains of dyspnea, palpitation, orthopnea and generalized edema. Above symptoms has been going for 4 months and NYHA classification was IV. On examination, blood eosinophil was 45 to 50% [WBC-9800 ]. MI and LV thrombi were confirmed by LV ventriculography and echocardiography. Pulmonary congestion and congestive cardiac failure were diagnosis by X-Ray examination, EKG finding and clinical feature and others there were no organic functional disturbance. Mitral valve replacement was performed with Ionescu-Shiley pericardial valve [29mm] replacement. Adjust thumb sized grayish brown colored two thrombi were excluded, lodged in the apex and septal endocardium of LV. Endocardial fibrosis was reliably confirmed under the gross pathology in the heart. The patient had smooth postoperative course and there were no operative complication.

• Journal of Chest Surgery
• /
• v.21 no.5
• /
• pp.899-904
• /
• 1988

In Behcet syndrome, cardiac involvements are rare and have been reported pericarditis, myocarditis, right heart endocardial fibrosis, right ventricle mural thrombus with pulmonary embolism, active endocarditis, granulomatous endocarditis, conduction disturbance, acute aortic insufficiency, mitral valve prolapse. Our three patients underwent AVR because of aortic insufficiency and ascending aorta enlargement combined with Behcet syndrome. Two patients had mitral regurgitation too. So one underwent MAP and the other underwent MVR concomitantly. One who underwent AVR have been well for 50 months. Another who underwent AVR+MAP and redo AVR due to aortic paravalvular leakage was died of congestive heart failure. The other who underwent AVR+MVR and repeated AVR three times because of aortic paravalvular leakage is in condition of aortic paravalvular leakage. Paravalvular leakage is considered to recur due to progressive dilatation and fragility of aortic root that is the result of pathologic change of Behcet syndrome in it. If Open heart surgery is needed in Behcet`s syndrome during inflammatory reaction is active, postoperative complications such as paravalvular leakage or suture line rupture may be prevented with pre- and postoperative anti-inflammatory management.