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Phase 2 TJ > thoracic cavity /CV > Flashcards

thoracic cavity /CV Flashcards

1
Q
  • Hennet, JFMS 2022. Closure-related complications after median sternotomy in cats: 26 cases (2010–2020)

complication rate? how were they closed?

A

o 7% complications – related to closure of sternotomy – not SSI or dehiscence

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2
Q
  • Pilot, VS 2022. Comparison of median sternotomy closure-related complication rates using orthopedic wire or suture in dogs

complication rate? which closure was better?
what was associated with inc complications?

A

o Use of orthopedic wire or suture are appropriate closure methods for sternotomy in dogs of any size
o 14% complications – only factor assoc w/ inc risk of closure complications was dog size
 lower than previously reported (17%–78%)

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3
Q
  • Racette, JVECC 2022. Retrospective evaluation of fluid production at the time of thoracostomy tube removal following elective and emergency surgery in dogs (2010–2017): 185 cases

what was assoc/ persistent effusion at 2 wks? what was not associated with effusion?

A

o Pleural effusion @ 2 wks= 7% dogs; more common if preop PE, chylothorax, or LLT
 Fluid prod @ tube pull was NOT assoc persistent effusion @ 2wk

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4
Q
  • Liptak, VS 2008. Reconstruction of Chest Wall Defects After Rib Tumor Resection: A Comparison of Autogenous, Prosthetic, and Composite Techniques in 44 Dogs

complication rate bw autogenous and prosthetics?
recc for mesh use? what type of mm flap is lat?

A

o Complications= autogenous = 10%, composite= 25%, prosthetic =65%
 prosthetic mesh should be covered with muscle/omentum to decrease the risk of postoperative complications
o mm flaps latissimus = type V flap (thoracodorsal); deep pec = type V flap (lateral thoracic)

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5
Q
  • Dickson, VS 2024. Outcome of video‐assisted thoracoscopic treatment of idiopathic chylothorax in 15 cats

persistent PE? recurrence rate? mortality rate?

A

o persistent pleural effusion = 33%
recurrence in 14%
o overall mortality = 47%

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6
Q
  • Carrol, JAVMA 2024. Thoracoscopic removal of cranial mediastinal masses in dogs is associated with a low conversion rate, excellent survival to discharge, and good long-term outcome

negative prognostic indicators and relative %?
MST for thymoma vs thymoma/MG?

A

o Preop myasthenia gravis = 35%; megaesophagus =22% – negative prognostic indicators

o MST thymoma = 1,102 days (3yr) vs thymoma/MG =182 d (6mo)

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7
Q
  • Johnson, JVIM 2023. Etiology and effusion characteristics in 29 cats and 60 dogs with pyothorax (2010-2020)

causes in dog vs cats? cat pyothorax bacteria? dog bacteria?

A

dogs = FB inhalation vs cats = bites/trauma

Cats = polymicrobial, anaerobic (73%)  cats = higher cell counts, polymicrobial, intracell bacteria
 Pasteurella (aerobic) & bacteriodies/fuso/peptostrep most common (oral flora)
o Dogs = one microbe, aerobes more common – actinomyces/strep/staph

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8
Q
  • Marks, JSAP 2023. Prognostic factors and outcome in cats with thymic epithelial tumours: 64 cases (1999‐2021)

MST? mortality rate?

A

o MST = 897d (2.5yr)
o mortality rate = 11%

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9
Q
  • Mayhew, JAVMA 2022. Resolution, recurrence, and chyle redistributions and thoracic duct ligation with or without pericardiectomy in dogs with naturally occurring idiopathic chylothorax

resolution rates for TDL alone or TDL/P (if CPP)? recc for pericardiectomy?

A

o Resolution rates: TDL (no CP) = 94% vs TDL/P (yes CP) =88%
o In dogs w/o evidence of CPP, TDL alone was assoc w/ a very good px – if no CPP benefit of pericardiectomy is questionable

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10
Q
  • Kanai, VRU 2021. Canine idiopathic chylothorax: Anatomic characterization of the pre and postoperative thoracic duct using computed tomography lymphography
    % of pts w/ obvious TD after 1wk postop?
A

o 1 wk postop CT lymphangio identified 50% of TD – poss d/t “invisible or sleeping” fine ducts not seen on preop CTL

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11
Q
  • Kramer, JSAP 2021. Short and long term outcome in cats diagnosed with pyothorax: 47 cases (2009-2018)

med mgmt failure rate? mortality rate? recur?

A

15% failed med mgmt then had surgery
o 28% mortality rate & Recurrence rate = 6%

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12
Q
  • Dickson, JAVMA 2021. Surgical management and outcome of dogs with primary spontaneous pneumothorax: 110 cases (2009–2019)

recurrence rate?

A

o Recurrence = 13% – most likely <30d after sx

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13
Q
  • Kanai, Vet Surg 2020. Efficacy of en bloc thoracic duct ligation in combination with pericardiectomy by video assisted thoracocscopic surgery for canine idiopathic chylothorax

remisson rate for en bloc vs conventional?

A

o Clinical improvement = 91.7%
o Remission rates higher w/ en bloc-TDL (85.7%) group vs conventional TDL (20%)

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14
Q
  • Mayhew, Vet Surg 2019. Long term outcome of video assisted thoracoscopic thoracic duct ligation and pericardectomy in dogs with chylothorax: a multiinstitution study of 39 cases
    resolution rates?
A

o Resolution =95%

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15
Q
  • Stockdale, JAVMA 2018. Comparison of thoracic duct ligation plus subphrenic pericardiectomy with or without cisterna chyli ablation for treatment of idiopathic chylothorax in cats

recc for CCA?

A

o Addition of CCA to sx – longer GA w/ no better outcome

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16
Q
  • Garneau, VS 2015. Perioperative Mortality and Long‐Term Survival in 80 Dogs and 32 Cats Undergoing Excision of Thymic Epithelial Tumors

mortality rates for dog v cat? MST? what is associated with w dec survival?

A

o Mortality: dogs =20% vs cats= 22%
o MST: dogs = 1.5yr vs cats = 3.5yr
o Survival decreased w/ paraneoplastic syndromes or incomplete margins

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17
Q
  • Meakin. JSAP 2013. Prevalence, outcome and risk factors for postoperative pyothorax in 232 dogs undergoing thoracic surgery

mortality rate?

A

o 67% mortality rate

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18
Q
  • Boothe, JAVMA 2010. Evaluation of outcomes in dogs treated for pyothorax: 46 cases (1983-2001)

survival rate for sx vs chest tube vs thoracocentesis

A

o survival rate: thoracocentesis =29%; chest tubes=77%; surgery = 92%

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19
Q
  • Mcnamara, JAVMA 2023. Risk factors for intraoperative hemorrhage and perioperative complications and short- and long-term outcomes during surgical patent ductus arteriosus ligation in 417 dogs

intraop hemorrhage rate? % of dogs surviving intraop hemorrhage? mortality rate?

A

o Intraop hemorrhage = 11%  95% with intraop hemorrhage survived
o intraop mortality =2%  97% survived to discharge

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20
Q
  • Grimes, VS 2022. Surgical ligation of patent ductus arteriosus in dogs: Incidence and risk factors for rupture
    intraop hemorrhage? mortality rate?
    factors not associated with rupture?
A

o Intraop rupture = 7% Mortality rate = 0.4%
o Residual PDA flow = 9%  dogs w/ rupture were more likely to have residual flow (but if ligation re-attempted then no diff)
o Age and weight not assoc w/ inc risk for hemorrhage (same as Mcnamara 2023)

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21
Q
  • Raleigh et al. JAVMA 2022. The development of ventricular fibrillation as a complication of pericardiectomy in 16 dogs

assoc bw vfib and use of electrosx? mortality rate?

A

o Vfib assoc w/ electrosx = 53%  93% dogs had electrosx used intraop
o Preop arrhythmias = 45%
o Mortality rate = 87% (d/t Vfib)

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22
Q
  • Carvajal et al, JAVMA 2019. Outcome in dogs with presumptive idiopathic pericardial effusion after thoracoscopic pericardiectomy and pericardioscopy

% w/ lesions on pericardioscopy? MST if lesions?

conclusion

A

o 0% had lesions on echo  50% had abN on pericardioscopy (mass/nodule/adhesion)
o MST: lesions = 66d (2mo)(1’ mesothelioma) vs no lesions = not reached
o Recc thoracoscopic pericardectomy/pericardioscopy + targeted bx for dogs with idiopathic PE

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23
Q
A
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24
Q

What was the primary finding of Mihara et al, Vet Surg 2024 regarding mitral valve repair in dogs?

A

Mitral valve geometry was completely changed within 1 week and VHS lasted for ~3mo

Mitral valve repair changed valvular geometry and improved hemodynamics, leading to postoperative morphological modification and coaptation area creation.

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25
Q

What percentage of dogs experienced intraoperative hemorrhage during patent ductus arteriosus ligation according to Mcnamara, JAVMA 2023?

A

11%

95% with intraoperative hemorrhage survived, and 44% received blood transfusions.

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26
Q

What was the intraoperative mortality rate reported by Mcnamara, JAVMA 2023?

A

2%

97% of dogs survived to discharge.

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27
Q

According to Grimes, VS 2022, what was the incidence of intraoperative rupture during patent ductus arteriosus ligation?

A

7%

Mortality rate associated with intraoperative rupture was 0.4%.

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28
Q

What was the residual patent ductus arteriosus flow percentage reported in Grimes, VS 2022?

A

9%

Dogs with rupture were more likely to have residual flow, but if ligation was re-attempted, then no difference was observed.

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29
Q

What association was found between preoperative arrhythmias and electrosurgery in the study by Raleigh et al., JAVMA 2022?

A

Ventricular fibrillation was associated with electrosurgery in 53% of cases

93% of dogs had electrosurgery used intraoperatively.

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30
Q

What was the mortality rate due to ventricular fibrillation in the study by Raleigh et al., JAVMA 2022?

A

87%

This was specifically due to ventricular fibrillation.

31
Q

What did Chmelvoski, VS 2021 find regarding the use of external jugular vein grafts in dogs?

A

Autologous external jugular vein grafts had an external diameter similar to subclavian artery and a significantly longer length

This makes them acceptable for use with modified Blalock-Taussig shunt.

32
Q

What are the components of Tetralogy of Fallot as described in the study by Chmelvoski, VS 2021?

A
  • Interventricular septal defect
  • Right ventricular hypertrophy
  • Overriding aorta
  • Pulmonic stenosis
33
Q

What was the outcome for dogs with idiopathic pericardial effusion treated with thoracoscopic pericardiectomy and pericardioscopy according to Carvajal et al, JAVMA 2019?

A

0% had lesions on echo, while 50% had abnormalities on pericardioscopy

MST for lesions was 66 days (primary mesothelioma) vs not reached for no lesions.

34
Q

What was the median survival time for dogs with neoplasia after treatment according to Michelotti et al, JAVMA 2019?

A

76 days (2 months)

Dogs without cancer had a median survival time of 1 year.

35
Q

What percentage of dogs experienced recurrent pleural effusion leading to death as reported by Michelotti et al, JAVMA 2019?

A

50%

This was noted in dogs with recurrent pleural effusion.

36
Q

What was the focus of the study by Barbur, VS 2018 regarding thoracoscopic pericardectomy?

A

Epicardial exposure provided by a novel thoracoscopic pericardectomy technique compared to standard pericardial window

The novel technique improves exposure of the epicardium.

37
Q

What is the prevalence of spontaneous pneumomediastinum in sighthounds compared to other breeds?

A

14% in sighthounds vs 2% in other breeds

Not associated with pulmonary pathology or general anesthesia.

38
Q

What is the Macklin effect?

A

Gas leaks from the alveoli into interstitial lung tissue leading to pneumomediastinum.

39
Q

What was the survival rate reported after median sternotomy closure in cats?

A

81%

Closure was performed with suture in all cats.

40
Q

What were the complication rates associated with median sternotomy closure in dogs using orthopedic wire or suture?

A

14% complications with an even split between both groups

Only factor associated with complications was dog size.

41
Q

What factors were associated with higher fluid production during thoracostomy tube removal?

A

Preoperative effusion or median sternotomy.

42
Q

What is the primary cause of pyothorax in dogs and cats?

A

Dogs: foreign body inhalation; Cats: bites/trauma.

43
Q

What percentage of cats with neoplasia had an increased risk of death?

A

2x increased risk

Neoplasia was the most common cause of bicavitary effusion.

44
Q

What are the most common complications related to closure of median sternotomy?

A

7% complications related to closure, not surgical site infection or dehiscence.

45
Q

What is the mortality rate associated with surgical treatment of thoracic trauma in cats?

A

13%

Increased risk of death with cardiopulmonary arrest and higher triage scores.

46
Q

What is the effect of muscle-sparing lateral thoracotomy on postoperative pain?

A

Decreased postoperative pain and thoracic lameness.

47
Q

What is the prognosis for dogs with thymic epithelial tumors based on tumor stage?

A

MST: 1366d for stage I/II vs 454d for stage III/IV.

48
Q

What is the overall mortality rate following video-assisted thoracoscopic treatment of idiopathic chylothorax in cats?

A

47%.

49
Q

What is the common outcome for dogs with pneumothorax following nasogastric feeding tube misplacement?

A

70% developed respiratory signs and 40% had cardiopulmonary arrest.

50
Q

What are the types of closure techniques compared in canine median sternotomy?

A

Suture tape and orthopedic wire cerclage.

51
Q

What is the complication rate for autogenous, composite, and prosthetic techniques in chest wall reconstruction?

A
  • Autogenous: 10%
  • Composite: 25%
  • Prosthetic: 65%

Prosthetic mesh should be covered with muscle/omentum to reduce complications.

52
Q

How did the use of orthopedic wire compare to suture in sternotomy closure in terms of biomechanical properties?

A

Suture tape was biomechanically similar to orthopedic wire, but wire constructs were stiffer.

53
Q

What are the common clinical signs associated with traumatic pneumomediastinum?

A
  • Subcutaneous emphysema
  • Pneumothorax
  • Dyspnea.
54
Q

What is the recommended preoperative treatment for dogs with myasthenia gravis undergoing thoracoscopic surgery?

A

Pyridostigmine (acetylcholinesterase inhibitor) for 2 weeks preoperatively.

55
Q

What factors influence the duration of chest tube usage following thoracic surgery in dogs and cats?

A
  • Median sternotomy
  • Rib resection
  • Preoperative pleural effusion.
56
Q

What is the most common surgical treatment for idiopathic chylothorax in dogs?

A

TDL + subtotal pericardiectomy (40%)

TDL stands for thoracic duct ligation.

57
Q

What is the most common surgical treatment for idiopathic chylothorax in cats?

A

Thoracic duct ligation (51%)

58
Q

What was the resolution rate for video assisted thoracoscopic thoracic duct ligation and pericardectomy in dogs?

A

95%

Late recurrence rate was 9%.

59
Q

What is the significance of the study by Mayhew in 2019 regarding chylothorax in dogs?

A

Successful outcome of VATS TDL + pericardectomy.

60
Q

In the study by Singh in 2019, what were the surgical approaches optimized for?

A

Thoracoscopic‐assisted pulmonary surgery in dogs.

61
Q

What percentage of foreign bodies were retrieved via bronchoscopy in the study by Gibson in 2019?

A

37%

70% were retrieved surgically.

62
Q

What was the survival rate reported by Gibson in 2019 for dogs with intrathoracic disease?

A

95%

63
Q

What was the median survival time (MST) for cats treated with TDL + pericardiectomy?

A

774 days

64
Q

What was the MST for cats treated with TDL/PC/CCA?

A

380 days

65
Q

True or False: The addition of cisterna chyli ablation (CCA) to surgery improved outcomes in cats with idiopathic chylothorax.

A

False

It resulted in longer general anesthesia with no better outcome.

66
Q

What percentage of sites showed recanalization after video assisted thoracoscopic thoracic duct sealing in healthy cats?

A

80%

67
Q

What were the mortality rates associated with excision of thymic epithelial tumors in dogs and cats?

A

Dogs: 20%; Cats: 22%

68
Q

What was the median survival time for dogs versus cats undergoing excision of thymic epithelial tumors?

A

Dogs: 1.5 years; Cats: 3.5 years

69
Q

What was the percentage of dogs that developed postoperative pyothorax in the study by Meakin?

A

6%

70
Q

What was the mortality rate associated with postoperative pyothorax in dogs?

A

67%

71
Q

What was the survival rate for dogs treated with thoracocentesis, chest tubes, and surgery for pyothorax?

A

Thoracocentesis: 29%; Chest tubes: 77%; Surgery: 92%

72
Q

What factors were associated with decreased survival in dogs undergoing excision of thymic epithelial tumors?

A

Paraneoplastic syndromes or incomplete margins

73
Q

What was the disease-free rate at 1 year for medical management versus surgical treatment of pyothorax in dogs?

A

Medical management: 25%; Surgical treatment: 78%

74
Q

Fill in the blank: The likelihood of treatment failure in dogs treated medically for pyothorax was _______ times higher than in those treated surgically.

A

5.4

Phase 2 TJ (6 decks)

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