Key result
Canine tricuspid valve repair under CPB is associated with a ~61% hypotension rate.
Why the study?
Open-heart surgery under cardiopulmonary bypass for tricuspid valve dysplasia in dogs is high-risk and requires detailed understanding of anaesthetic management and complications.
Observational (n=18)
Open-heart surgery for tricuspid valve repair under cardiopulmonary bypass in dogs is a high-risk procedure, with hypotension being the most frequent anaesthetic complication.
Hypotension predominates with notable mortality in this small canine series; leaves open larger prospective studies to refine veterinary cardiopulmonary bypass protocols.
Tricuspid valve dysplasia is a congenital malformation in dogs.Open-heart surgery is the only option for correction of severe tricuspid regurgitation1.We describe the anaesthetic management and complications in dogs undergoing tricuspid valve repair under cardiopulmonary bypass (CPB) between May 2019 and December 2025.A total of 18 anaesthetic records were reviewed and analysed descriptively.Labrador Retriever was the most represented breed (66.7%).The median age was 12 (6-36) months and median body weight was 26 (18-37) kg.Median anaesthesia and CPB times were 330 (275-720) and 60 (30-80) minutes, respectively; mean (± SD) surgery time was 185 ± 37 minutes.In three dogs ventricular fibrillation was induced with an electric shock during CPB.Methadone was administered for premedication.Anaesthesia was induced with midazolam and either alfaxalone (50%) or propofol (50%).Isoflurane and propofol were used as maintenance agents during the off-pump and CPB periods, respectively.Thoracic paravertebral block, paracetamol, and infusions of fentanyl and ketamine were administered for multimodal analgesia.Positive pressure ventilation (PPV) was applied in all patients; during the CPB period, a TV of 10 ml kg-1 and a fR of 4-6 breaths min-1 were set.Sildenafil, dexamethasone, chlorphenamine, and cefazolin were also administered.Eight cases received blood products during the procedure.Hypotension (MAP < 60 mmHg) was the most common complication (11/18) both during the off-pump (8/ 11) and CPB (6/11) periods.Noradrenaline or dobutamine were administered as the sole agent in 2/11 and 3/11 cases, respectively, or in combination (6/11).One dog experienced hypoxaemia (PaO2 < 60 mmHg), and one died intraoperatively due to failure to wean from CPB.Two dogs died in the immediate postoperative period: one developed acute respiratory distress syndrome and one major hemorrhage.Open-heart surgeries under CPB are high-risk procedures; anaesthetic management is challenging and requires close teamwork and appropriate equipment.
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Stefania et al. (2026) conducted an observational in Tricuspid valve dysplasia (n=18). Surgical tricuspid valve repair under cardiopulmonary bypass was evaluated on Complications. In 18 dogs undergoing tricuspid valve repair under cardiopulmonary bypass, hypotension was the most common complication (11/18), and 3 dogs died intra- or postoperatively.
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