Pre- and post-operative cardiac evaluation of dogs undergoing lobectomy and pneumonectomy

Abstract

This study aimed to assess the influence of lobectomy and pneumonectomy on cardiac rhythm and on the dimensions and function of the right-side of the heart. Twelve dogs undergoing lobectomy and eight dogs undergoing pneumonectomy were evaluated preoperatively and one month postoperatively with electrocardiography and Doppler echocardiography at rest. Pulmonary artery systolic pressure (PASP) was estimated by the tricuspid regurgitation jet (TRJ) via the pulse wave Doppler velocity method. Systemic inflammatory response syndrome criteria (SIRS) were also evaluated based on the clinical and hematological findings in response to lobectomy and pneumonectomy. Following lobectomy and pneumonectomy, we predominantly detected atrial fibrillation and varying degrees of atrioventricular block (AVB). Dogs that died within seven days of the lobectomy (n = 2) or pneumonectomy (n = 1) had complete AVB. Preoperative right atrial, right ventricular, and pulmonary artery dimensions increased gradually during the 30 days (p<0.05) following pneumonectomy, but did not undergo significant changes during that same period after lobectomy. Mean PASP was 56.0 ± 4.5 mmHg in dogs having significant TRJ after pneumonectomy. Pneumonectomy, but not lobectomy, could lead to increases (p<0.01) in the SIRS score within the first day post-surgery. In brief, it is important to conduct pre- and postoperative cardiac evaluation of dogs undergoing lung resections because cardiac problems are a common postoperative complication after such surgeries. In particular, complete AVB should be considered a life-threatening complication after pneumonectomy and lobectomy. In addition, pneumonectomy appears to increase the likelihood of pulmonary hypertension development in dogs.

Outcome After Pneumonectomy in 17 Dogs and 10 Cats: A Veterinary Society of Surgical Oncology Case Series

“…Approximately half (14/27) underwent pneumonectomy for neoplasia with 10 animals having pulmonary adenocarcinoma. This distribution is consistent with the 14 cases of pneumonectomy previously described in the veterinary literature, where 7 were treated for neoplasia.…”

“…Complications in respiratory, cardiac and gastrointestinal function are reported with pneumonectomy in small animals . Respiratory complications (persistent pleural effusion, oxygen dependence, persistent increased respiratory rate, or coughing) were most frequent in this study.…”

“…Pneumonectomy, defined as surgical excision of the entire left or right lung, is an infrequent procedure in veterinary surgery. Several reports have described outcome after pneumonectomy in dogs and cats, although two reports did not focus on outcome with one study assessing the impact pneumonectomy on the right‐side cardiac function and the another report focusing on the anesthesia and perioperative management of a pneumonectomized dog . Factors associated perioperative mortality, complications, or successful outcome remain largely unknown in dogs and cats.…”

“…The primary indication for pneumonectomy in people for treatment of lung cancer . In the 14 cases of pneumonectomy thus far reported in the veterinary literature, 7 were for neoplasia …”

Retrospective study of pre-anesthetic electrocardiogram examination of 700 dogs conducted at the Veterinary Hospital of UFMG (2013-2014)

“…In pre-anesthetic evaluation, ECG should be considered a routine examination and mandatory for the anesthetic procedure, used as a guide for choosing the most suitable drugs to be used for each patient (Fantoni & Cortopassi 2002, Kocatürk et al 2010. During trans-anesthetic period some complications should be considered, such as cardiopulmonary arrest, hypoventilation, hypotension and arrhythmias, including tachyarrhythmias and bradyarrythmias which require an ECG monitoring to be correctly identified.…”