The Cardiothoracic Surgery team

It is two decades since the RVC started offering pioneering – and often lifesaving – surgery to help dogs with complex heart conditions. This service is now one of the leading centres in the world for cardiothoracic surgery and continues to evolve.

The Cardiothoracic Surgery Service was established by Dan Brockman, who joined the RVC in 2000. When Professor Brockman first arrived, there was limited intensive care provision but with the support of Professor David Church, Amanda Boag and others, including dedicated veterinary nurses, an Intensive Care Unit (ICU) with round the clock staffing was established.

The ICU and the (also new) Transfusion Medicine Service and Blood Donor Programme were foundations enabling the Cardiothoracic Surgery Service to emerge.

The blood transfusion requirements have changed significantly over the decades. Initially each dog required two or three units of fresh whole blood but now patients, which are typically smaller and primarily mitral valve disease cases, only require packed red cells.

Cardiopulmonary bypass equipment also was required to get the service off the ground and an experienced NHS perfusionist, Alan Akins, joined the team. Later, when Alan retired, Nigel Cross, a paediatric perfusionist from Great Ormond Street Hospital, joined the team.

Early cases     

The first patient to benefit from the service was a dog called Monty, who was treated, in January 2005, for tricuspid valve dysplasia. Though the surgery was successful, the team recognised that developing surgical expertise for different cardiac disorders would take time.

Between 2005 and 2012 one patient a month was scheduled, primarily tricuspid valve replacements, pulmonic stenosis surgery and double chamber right ventricle surgery.

The leading surgeons for veterinary mitral valve surgery were based in Japan and Professor Brockman knew them from international meetings. A team from Japan visited the RVC in 2012 and successfully operated on Heidi, a Jack Russell, with Dan Brockman assisting.

The team from Japan returned periodically over the next four years and operated on six dogs at the RVC. Having observed the surgeons from Japan over the years, the RVC team did its first mitral valve repair independently in 2015.

In 2017, the team’s progress was supported by the addition of a Cardiothoracic Surgery Fellow, a Perfusion Fellow and two veterinary nurses dedicated to the programme.

By this time, the team had treated several very sick dogs that recovered extremely well. By the end of 2018 we were doing two operations a week. In 2020 COVID hit and it was more than a year before we could resume cases. A significant development at that point was Matteo Rossanese, from the Soft Tissue Surgery Service, coming to work with us.

We gradually increased the number of cases to where we were before COVID struck but we still have a long waiting list. We aspire to increase our capacity, planning to double the number of operations we can perform each year. 

Timeline   

2000   

Dan Brockman joined the RVC, having previously worked at the University of Pennsylvania’s School of Veterinary Medicine, which had been working towards a cardiothoracic surgery service.

2001 to 2004  

The Critical Care Service and Intensive Care Unit were established, by Dez Hughes.

The Transfusion Medicine Service was formalised by 2004, led by Gill Gibson and Amanda Boag.   

2005     

The RVC Cardiothoracic Surgery Service was established. A dog called Monty with tricuspid valve dysplasia was the first patient, in January 2005.   

2005 to 2011   

One case a month was scheduled.   

2012 to 2015   

Between 2012 and 2015 a surgical team from Japan visited the RVC to operate on dogs with mitral valve disease.

In 2015 The RVC team did its first mitral valve repair without support from surgeons from Japan.   

2016   

Surgery on a dog called Mabel, to treat a stenotic tricuspid valve, was carried out at the RVC. It is the first reported case globally of such a procedure being successfully performed on a dog.  

2017 to 2019

The team was enhanced by a Cardiothoracic Surgery Fellow, a Perfusion Fellow and two veterinary nurses. 

After successfully treating several dogs that recovered well, the team was able to significantly increase our caseload to treat two dogs each week.   

2020 to 2021   

In 2020 the service paused due the COVID pandemic and was resumed in the second half of 2021. 

Matteo Rossanese joined the RVC, working within the Soft Tissue Surgery Service. He subsequently joined the Cardiothoracic Surgery team.   

2024 to 2025        

Members of our team visited the Jasmine Clinic in Japan, which currently performs up to 40 mitral valve repairs each month, to explore ways in which we could significantly increase our caseload.