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Parasternal Thoracotomy: Review of Twenty-Eight Cases

Received: 2 August 2021    Accepted: 16 August 2021    Published: 24 August 2021
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Abstract

Pericardiectomy is the preferred surgical procedure for the treatment of pericardial effusions with cardiac tamponade. Surgery is indicated in all cases of recurrent effusions after pericardiocentesis. In the literature, the most frequently used surgical procedure is subtotal pericardiectomy. More recently, minimally invasive techniques have allowed a reduction of morbidity compared to traditional procedures. Aim of this paper is to selectively use the new minimally invasive pericardiectomy technique already described in our previous article and to document the results in a series of twenty-eight cases. Twenty-eight dogs underwent complete blood and urine tests, ultrasound examination, pericardiocentesis and CT scan. In all cases the pericardiectomy was performed via a left parasternal thoracotomy through the seventh intercostal space. All the portions of resected pericardium were measured and histologically examined. All dogs had a neoplastic mass at the base of the heart and no recurrence of the pericardial effusion. All dogs were discharged 24 hours after surgery. Parasternal pericardiectomy may be a good option for the minimally invasive treatment of recurrent pericardial effusions, particularly in the presence of neoplastic lesions of the heart base. The morbidity of the approach is similar to that of other known procedures but it is potentially faster and easier to perform. No dedicated instrumentation is required.

Published in Animal and Veterinary Sciences (Volume 9, Issue 4)
DOI 10.11648/j.avs.20210904.16
Page(s) 121-127
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Pericardial Fenestration, Minimally Invasive Surgery, Parasternal Access

References
[1] Michael G, Aronsohn, JL, Carpenter Surgical treatment of idiopathic pericardial effusion in the dog: 25 cases (1978-1993). Journal of the American Animal Hospital Association 35: 521-525, 1999.
[2] Kyle K, Kerstetter, DJ, Krahwinkel JR Darryl L, Millis et al. Pericardiectomy in dogs: 22 cases (1978-1994). Journal of the American Veterinary Medical Association, September 15, volume 211, n° 6: 736-740, 1997.
[3] Shaw SP, Rush JE Canine pericardial effusion: diagnosis, treatment and prognosis. CompendiumVet.com, July: 405-411, 2007. URL: Canine Pericardial Effusion. Available at: http://www.researchgate.net/publication/6113442_Canine_pericardial_effusion.
[4] Sidley JA, Atkins CE, Keene BW et al. Percutaneous Balloon Pericardiotomy as a treatment for recurrent pericardial effusion in 6 dogs. Journal of Veterinary Internal Medicine 16: 541-546, 2002.
[5] De Ridder M, Kitshoff A, Devriendt N et al. Transdiaphragmatic pericardiectomy in dogs. Veterinary Record (Official Journal of British Veterinary Association) volume 180, n° 4: 1-6, 2016. URL: Transdiaphragmatic pericardiectomy. Available at: http://www.veterinaryrecord.bmj.com/content/180/4/95 or doi: 10.1136/vr.103962.
[6] Jackson J, Richter KP and Launer DP Thoracoscopic partial pericardiectomy in 13 dogs. Journal of Veterinary Internal Medicine, 13: 529- 533, 1999.
[7] Atencia S, Doyle RS and Whitley NT Thoracoscopic pericardial window for management of pericardial effusion in 15 dogs. Journal of Small Animal Practice, November 54: 564-569, 2013.
[8] Dupre’ GP, Corlouer JP, Bouvy B Thoracoscopic pericardiectomy performed without pulmonary exclusion in 9 dogs. Veterinary Surgery, 30: 21-27, 2001.
[9] Abarkar M, Sharifi D, Kariman A et al. Evaluation of intraoperative complications in pericardiectomy with transdiaphragmatic thoracoscopic approach in dog. Iranian Journal of Veterinary Surgery, volume 2, n° 4: 62-68, 2007.
[10] Laura A. Barbur Clarence A. Rawlings MaryAnn G. Radlinsky Epicardial exposure provided by a novel thoracoscopic pericardectomy technique compared to standard pericardial window Veterinary Surgery.
[11] Chad Schmiedt What is the optimal approach for pericardiectomy in dogs? Veterinary Record | January 28, 2017.
[12] Case JB, Maxwell M, Aman A et al. Outcome evaluation of thoracoscopic pericardial window procedure or subtotal pericardiectomy via thoracotomy for treatment of pericardial effusion in dogs. Journal of American Veterinary Medical Association, February 15, volume 242, n° 4: 493-498, 2013.
[13] Nguyen Thanh Liem, To Tuan and Le Anh Dung, Thoracoscopic pericardiectomy for purulent pericarditis: experience with 21 cases. Journal of Laparoendoscopic & Advanced Surgical Techniques, volume 16, n° 5: 518-521, 2006.
[14] Walsh PJ, Remedios AM, Ferguson JF et al. Thoracoscopic versus open partial pericardiectomy in dogs: comparison of postoperative pain and morbidity. Veterinary Surgery, 28: 472-479, 1999.
[15] Vicari ED, Brown DC, Holt DE et al. Survivor times of and prognostic indicators for dogs with heart base masses: 25 cases (1986-1999). Journal of American Veterinary Medical Association, August 15, volume 219, n° 4: 485-487, 2001.
[16] Ehrhart N, Ehrhart J, Willis J et al. Analysis of factor affecting survival in dogs with aortic body tumours. Veterinary Surgery 31: 44-48, 2002.
[17] Weisse C, Soares N, Beal MW et al. Survival times in dogs with right atrial hemangiosarcoma treated by means of surgical resection with or without adjuvant chemotherapy: 23 cases (1986-2000). Journal of American Veterinary Medical Association, February 15, volume 226, n° 4: 575-579, 2005.
[18] Aronsohn M. Cardiac hemangiosarcoma in the dog: a review of 38 cases. Journal of American Animal Hospital Association, 187: 922-926, 1985.
[19] P T. Gunasekaran, N. B. Olivier, Smedley, R. A. Sanders, Pericardial Effusion in a Dog with Pericardial Hemangiosarcoma Journal of Veterinary Cardiology (2019) 23, 81e87.
[20] M. DeSandre-Robinson, Mariana T. Quina, David M. Lurie, Pericardial Hemangiosarcoma in a 10-Year-Old Papillon Journal of the American Animal Hospital Association | 54: 5 Sep/Oct 2018.
[21] T Denise M. Crumbaker, Matthew B. Rooney, J. Brad Case, Thoracoscopic subtotal pericardiectomy and right atrial mass resection in a dog Journal of the American Veterinary Medical Association, Vol 237, No. 5, September 1, 2010.
[22] Hellen Fialho HARTMANN, Marília Teresa de OLIVEIRA, João Pedro Scussel FERANTI, Gabriela Pesamosca CORADINI, Stephanie Lanzarini ABATI, Bibiana Zoppas PIEREZAN, Vanessa Zanchi SARTURI, Marcella Teixeira LINHARES, Álvaro José Chávez SILVA Francisco Miguel Sanchez MARGALLO, Anne Santos do AMARAL and Maurício Veloso BRUN Thoracoscopic pericardiectomy associated with fully implantable catheter via thoracoscopy 5 in the management of mesothelioma in a bitch Journal of Veterinary Medical Science. April 2019.
[23] Keaton R. S. Morgan, Christopher G. Dominic, Janet Beeler-Marfisi, Karlee Craig, Katie L. Hoddinott, Siobhan O’Sullivan, Ameet Singh Presumptive seeding metastasis of pericardial mesothelioma following repeated pericardiocentesis in a dog Canadian Veterinary Journal 2019; 60: 972–975.
[24] Skinner OT, Case JB, Ellison GW et al. Pericardioscopic imaging findings in cadaveric dogs: comparison of an apical pericardial window and sub-phrenic pericardiectomy. Veterinary Surgery, 43: 45-51, 2014.
[25] Johnson MS, Martin M, Binns S et al. A retrospective study of clinical findings, treatment and outcome in 143 dogs with pericardial effusion. Journal of Small Animal Practice, 45: 546-552, 2004.
[26] Stray-Gundersen J, Musch TI, Haidet GC et al. The effect of pericardiectomy on maximal oxygen consumption and maximal cardiac output in untrained dogs. Circulation Research, Journal of the American Heart Association, January 23, 523-530, 2017.
[27] Chan A, Rischin D, Clarke CP et al. Subxiphoid partial pericardiectomy with or without sclerosant instillation in the treatment of symptomatic pericardial effusion in patients with malignancy. Cancer, September 1, volume 68: 1021-1025, 1991.
[28] Jacky R, Nolan AM, Lynne HJM et al. Development of the short-form Glasgow Composite Measure Pain Scale (CMPS-SF) and derivation of an analgesic intervention score. Animal Welfare, volume 16, Supplement 1, May: 97-104 (8), 2007.
[29] Frizzi M, D’Ettorre P, Bertolini G, Angeloni L, Parasternal thoracotomy: a new minimally invasive approach to the pericardium. Veterinaria, February, vol 32, issue 1, 2018.
[30] Simon Cook Stefano Cortellini Karen Humm Retrospective evaluation of pericardial catheter placement in the management of pericardial effusion in dogs (2007–2015): 18 cases Journal of Veterinary Emergency and Critical Care. 2019; 1–5.
[31] Simon Cook Stefano Cortellini Karen Humm Prospective evaluation of pericardial catheter placement versus needle pericardiocentesis in the management of canine pericardial effusion Journal of Veterinary Emergency and Critical Care. 2020; 1–7.
[32] Jose L. Carvajal J. Brad Case | Philipp D. Mayhew | Jeffrey Runge Ameet Singh Sarah Townsend | Eric Monnet Outcome in dogs with presumptive idiopathic pericardial effusion after thoracoscopic pericardectomy and pericardioscopy Veterinary Surgery. 2018; 1–7.
[33] Terence A. Krentz Robert J. Schutrumpf Julie C. Zitz, Focal intramural pericardial effusion and cardiac tamponade associated with necrotic adipose tissue in a dog Journal of the American Veterinary Medical Association Vol 251 No. 2 July 15, 2017.
[34] Kurt P. Michelotti Ada Youk John T. Payne Jonathan Anderson Outcomes of dogs with recurrent idiopathic pericardial effusion treated with a 3-port right-sided thoracoscopic subtotal pericardiectomy Veterinary Surgery 2019, 1-10.
Cite This Article
  • APA Style

    Massimo Frizzi, Laura Ballarini, Davide Costa, Nicola De Quarto. (2021). Parasternal Thoracotomy: Review of Twenty-Eight Cases. Animal and Veterinary Sciences, 9(4), 121-127. https://doi.org/10.11648/j.avs.20210904.16

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    ACS Style

    Massimo Frizzi; Laura Ballarini; Davide Costa; Nicola De Quarto. Parasternal Thoracotomy: Review of Twenty-Eight Cases. Anim. Vet. Sci. 2021, 9(4), 121-127. doi: 10.11648/j.avs.20210904.16

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    AMA Style

    Massimo Frizzi, Laura Ballarini, Davide Costa, Nicola De Quarto. Parasternal Thoracotomy: Review of Twenty-Eight Cases. Anim Vet Sci. 2021;9(4):121-127. doi: 10.11648/j.avs.20210904.16

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  • @article{10.11648/j.avs.20210904.16,
      author = {Massimo Frizzi and Laura Ballarini and Davide Costa and Nicola De Quarto},
      title = {Parasternal Thoracotomy: Review of Twenty-Eight Cases},
      journal = {Animal and Veterinary Sciences},
      volume = {9},
      number = {4},
      pages = {121-127},
      doi = {10.11648/j.avs.20210904.16},
      url = {https://doi.org/10.11648/j.avs.20210904.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.avs.20210904.16},
      abstract = {Pericardiectomy is the preferred surgical procedure for the treatment of pericardial effusions with cardiac tamponade. Surgery is indicated in all cases of recurrent effusions after pericardiocentesis. In the literature, the most frequently used surgical procedure is subtotal pericardiectomy. More recently, minimally invasive techniques have allowed a reduction of morbidity compared to traditional procedures. Aim of this paper is to selectively use the new minimally invasive pericardiectomy technique already described in our previous article and to document the results in a series of twenty-eight cases. Twenty-eight dogs underwent complete blood and urine tests, ultrasound examination, pericardiocentesis and CT scan. In all cases the pericardiectomy was performed via a left parasternal thoracotomy through the seventh intercostal space. All the portions of resected pericardium were measured and histologically examined. All dogs had a neoplastic mass at the base of the heart and no recurrence of the pericardial effusion. All dogs were discharged 24 hours after surgery. Parasternal pericardiectomy may be a good option for the minimally invasive treatment of recurrent pericardial effusions, particularly in the presence of neoplastic lesions of the heart base. The morbidity of the approach is similar to that of other known procedures but it is potentially faster and easier to perform. No dedicated instrumentation is required.},
     year = {2021}
    }
    

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    T1  - Parasternal Thoracotomy: Review of Twenty-Eight Cases
    AU  - Massimo Frizzi
    AU  - Laura Ballarini
    AU  - Davide Costa
    AU  - Nicola De Quarto
    Y1  - 2021/08/24
    PY  - 2021
    N1  - https://doi.org/10.11648/j.avs.20210904.16
    DO  - 10.11648/j.avs.20210904.16
    T2  - Animal and Veterinary Sciences
    JF  - Animal and Veterinary Sciences
    JO  - Animal and Veterinary Sciences
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    PB  - Science Publishing Group
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    UR  - https://doi.org/10.11648/j.avs.20210904.16
    AB  - Pericardiectomy is the preferred surgical procedure for the treatment of pericardial effusions with cardiac tamponade. Surgery is indicated in all cases of recurrent effusions after pericardiocentesis. In the literature, the most frequently used surgical procedure is subtotal pericardiectomy. More recently, minimally invasive techniques have allowed a reduction of morbidity compared to traditional procedures. Aim of this paper is to selectively use the new minimally invasive pericardiectomy technique already described in our previous article and to document the results in a series of twenty-eight cases. Twenty-eight dogs underwent complete blood and urine tests, ultrasound examination, pericardiocentesis and CT scan. In all cases the pericardiectomy was performed via a left parasternal thoracotomy through the seventh intercostal space. All the portions of resected pericardium were measured and histologically examined. All dogs had a neoplastic mass at the base of the heart and no recurrence of the pericardial effusion. All dogs were discharged 24 hours after surgery. Parasternal pericardiectomy may be a good option for the minimally invasive treatment of recurrent pericardial effusions, particularly in the presence of neoplastic lesions of the heart base. The morbidity of the approach is similar to that of other known procedures but it is potentially faster and easier to perform. No dedicated instrumentation is required.
    VL  - 9
    IS  - 4
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Author Information
  • Surgery Department, San Marco Veterinary Clinic, Veggiano, Italy

  • Surgery Department, San Marco Veterinary Clinic, Veggiano, Italy

  • Surgery Department, San Marco Veterinary Clinic, Veggiano, Italy

  • Surgery Department, San Marco Veterinary Clinic, Veggiano, Italy

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