Key result
Pneumonectomy, but not lobectomy, significantly increased right ventricular dimensions (from 2.0 to 2.5 cm, p<0.05) and systemic inflammatory response syndrome scores, and was associated with a higher incidence of supraventricular tachycardia in dogs.
Why the study?
Does pneumonectomy or lobectomy affect cardiac rhythm and right heart function in dogs?
Observational (n=20)
No
Does pneumonectomy or lobectomy affect cardiac rhythm and right heart function in dogs?
Absolute Event Rate: 2.5% vs 2%
p-value: p=<0.05
Pneumonectomy, but not lobectomy, is associated with right heart remodeling and an increased risk of pulmonary hypertension and complete AV block in dogs.
May warrant RV monitoring after pneumonectomy in dogs; leaves open translation to humans and mechanisms.
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 lifethreatening complication after pneumonectomy and lobectomy. In addition, pneumonectomy appears to increase the likelihood of pulmonary hypertension development in dogs.
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KOCATÜRK et al. (2010) conducted an observational in Lung diseases requiring resection (tumors, pneumonia, trauma, inflammation) (n=20). Pneumonectomy vs. Lobectomy was evaluated on Right ventricular dimension at 30 days (p=<0.05). Pneumonectomy, but not lobectomy, significantly increased right ventricular dimensions (from 2.0 to 2.5 cm, p<0.05) and systemic inflammatory response syndrome scores, and was associated with a higher incidence of supraventricular tachycardia in dogs.
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