RVC investigated the benefits of a structured multidisciplinary approach.

A new study has explored how a structured approach to surgery could improve outcomes of myxomatous mitral valve disease (MMVD).

MMVD is the most common heart disease in dogs, affecting 3.5 per cent of canine population in the UK. Its progression can be unpredictable, but many dogs will develop fatal heart failure.

The disease is usually treated through open heart surgery – a procedure which is in its infancy with dogs. Mitral valve repair (MVR) surgery is currently only performed in specialist centres, including the Royal Veterinary College (RVC) Queen Mother Hospital for Animals.

Research has been conducted over the past few years, reaching a consensus that MVR surgery is an effective solution for many dogs.

This has included a canine MVR capability study, which a specialist RVC team has been undertaking since 2015. Led by Daniel Brockman, the team developed an approach and procedure for MVR for suitable candidates.

The clinical team recorded the mitral valve repairs they performed on 132 dogs between July 2015 and November 2022.

This data included a description of the standard practices of the team and the population of the dogs – including breed, age, gender and clinical condition. It also reported the short-term outcomes of the procedure, as well as any trends in causes or suspected causes of mortality, as it sought to understand any links between ‘technical’ and ‘disease’ factors.

There was a consistent trend of improved outcomes, with 30 of the last 33 dogs recovering from the procedure. Throughout the study period, 107 of the 132 dogs survived to discharge from the hospital.

The results suggest that any team performing MVR must have a high level of individual expertise. They must also have a high level of co-ordination and communication to make decisions and perform the procedure.

Researchers say that this co-ordination and communication is vital to reach agreements on suitable surgical candidates. Their individual expertise is also key to their competence with the technical aspects of a cardiopulmonary bypass (CPB) and their familiarity with relevant preoperative and intraoperative assessments.

Teams will also need to be competent with anesthetising dogs, understand the critical transition CPB and meet the postoperative requirements of dogs recovering from the story.

Prof Brockman, professor of small animal surgery at the RVC, said: “This manuscript represents the analysis of team performance in a complex sociotechnical environment.

“The results highlight the importance of team-working habits that include reflective and deliberate practice both by individuals and by the whole team delivering such a complex therapy.”

The full study can be found in the journal Veterinary Surgery.

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