Pericardioscopic imaging findings in cadaveric dogs: Comparison of an apical pericardial window and sub-phrenic pericardectomy

Authors

  • Owen T. Skinner BVSc,

    1. Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
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  • J. Brad Case DVM, MS, Diplomate ACVS,

    Corresponding author
    1. Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
    • Corresponding Author

      Dr. J. Brad Case, DVM, MS, Diplomate ACVS, Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, PO Box 100126, 2015 SW 16th Ave., Gainesville, FL 32608. E-mail: caseb@ufl.edu

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  • Gary W. Ellison DVM, MS, Diplomate ACVS,

    1. Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
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  • Eric L. Monnet DVM, PhD, Diplomate ACVS & ECVS

    1. Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado
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  • All cadaveric work was performed at the College of Veterinary Medicine, University of Florida, Gainesville, FL.

ABSTRACT

Objective

To compare the pericardioscopic cardiovascular anatomy visible between apical pericardial window (PW) and sub-phrenic pericardectomy (SPP).

Study Design

Experimental study.

Animals

Canine cadavers (n = 5).

Methods

Thoracoscopy was performed using a transdiaphragmatic subxyphoid and right and left intercostal portals. A 4 cm × 4 cm apical PW was created with endoscopic scissors. The intra-pericardiac structures were then pericardioscopically assessed using a subjective ordinal scale (0: not visible, 1: <50% seen, 2: >50% seen) before SPP. Assessment was repeated after SPP.

Results

An apical PW provided limited access to the cardiac structures, with only the right ventricle >50% visible in all cadavers. The right atrium, right auricle, left ventricle, right coronary artery, and interventricular paraconal branch of the left coronary artery were observed but were typically <50% visible after apical PW. The left atrium and auricle, and heart base could not be consistently seen through an apical PW. Sub-phrenic pericardectomy significantly improved observation of all intrapericardiac structures assessed, except for the right atrium and right ventricle.

Conclusions

PW centered over the cardiac apex limits evaluation of the pericardial space during pericardioscopy compared to SPP in cadaveric dogs.

Ancillary