Severe mitral regurgitation

Mitral valve disease in dogs has been previously discussed. Today’s case was a little different, because the leaflets were not as myxomatous in appearance as previous patients, yet the degree of regurgitation was one of the most severe we have encountered. The left atrium in this dog is extremely dilated, as is the mitral annulus, to the point where the valve leaflets no longer meet properly.

The left atrium has undoubtedly dilated over a long period of time, but the shape of the continuous wave Doppler trace is suggestive of a more recent worsening of mitral regurgitation (MR) severity. The left ventricle also still retains good contractility. This dog would likely recover very well from surgical intervention from expert mitral valve surgeons – with the success of the procedure shown to be very much dependent upon the experience of the surgeon, both in animal and human surgery. It’s for this reason that there are currently only two centres for canine mitral valve repair in the world, and we are lucky enough to have one of them in the UK in the form of Poppy Bristow, Dan Brockman and the rest of the team at the RVC. They would use an annuloplasty ring to reduce the size of the mitral valve annulus, as well as placing artificial chordae to support the leaflets.

Have a look at the case below, and note, in particular, the density and sharp profile of the continuous wave Doppler trace.