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Brockman et al: Improvement in short‐term outcome over time, in a single center embarking on a canine mitral valve repair program using a structured multidisciplinary approach
Veterinary Surgery 4, 2025

🔍 Key Findings

  • Overall survival to discharge: 107 of 132 dogs (81%)
  • Quartile improvement: Survival increased steadily from 67% in Q1 to 91% in Q4
    • Q1: 22/33 survived
    • Q2: 27/33
    • Q3: 28/33
    • Q4: 30/33
  • Statistical significance: Higher operative rank significantly associated with improved survival (p < .05)
  • Median cross clamp time (XCT): 73 min (range 40–165), but increased again in Q4
  • Fatalities (n=25) were often due to:
    • Failure to wean from CPB
    • Intracranial vascular events (stroke)
    • Intrathoracic hemorrhage
  • Breed representation: CKCS (23.5%), Chihuahua (22%), Crossbreeds (21%)
  • Stages of MMVD: Stage C (67%), Stage D (27%), Stage B2 (6%)
  • Emphasis on deliberate multidisciplinary teamwork for outcome improvement
  • Highlights importance of technical and non-technical team skills, procedural standardization, and consistent personnel

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← Articles

Brockman et al: Improvement in short‐term outcome over time, in a single center embarking on a canine mitral valve repair program using a structured multidisciplinary approach
Veterinary Surgery 4, 2025

🔍 Key Findings

  • Overall survival to discharge: 107 of 132 dogs (81%)
  • Quartile improvement: Survival increased steadily from 67% in Q1 to 91% in Q4
    • Q1: 22/33 survived
    • Q2: 27/33
    • Q3: 28/33
    • Q4: 30/33
  • Statistical significance: Higher operative rank significantly associated with improved survival (p < .05)
  • Median cross clamp time (XCT): 73 min (range 40–165), but increased again in Q4
  • Fatalities (n=25) were often due to:
    • Failure to wean from CPB
    • Intracranial vascular events (stroke)
    • Intrathoracic hemorrhage
  • Breed representation: CKCS (23.5%), Chihuahua (22%), Crossbreeds (21%)
  • Stages of MMVD: Stage C (67%), Stage D (27%), Stage B2 (6%)
  • Emphasis on deliberate multidisciplinary teamwork for outcome improvement
  • Highlights importance of technical and non-technical team skills, procedural standardization, and consistent personnel

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Multiple Choice Questions on this study

In Brockman 2025 et al., on canine mitral valve repair outcomes, what was the overall survival to discharge rate across the full cohort?

A. 66%
B. 72%
C. 81%
D. 87%
E. 91%

Answer: 81%

Explanation: 107 of 132 dogs survived to discharge, yielding an overall rate of 81%.
In Brockman 2025 et al., on canine mitral valve repair outcomes, which of the following best explains the improvement in short-term outcomes over time?

A. Use of newer cross clamp equipment
B. Smaller dog breed selection
C. Increased surgical caseload from multiple institutions
D. Structured multidisciplinary team and procedural consistency
E. Shorter bypass duration

Answer: Structured multidisciplinary team and procedural consistency

Explanation: The authors emphasize team structure, standardization, and deliberate practice as key contributors to outcome improvement.
In Brockman 2025 et al., on canine mitral valve repair outcomes, which factor was significantly associated with improved survival?

A. Cross clamp time
B. Breed size
C. Use of steroids
D. Operative rank
E. Anesthesia protocol

Answer: Operative rank

Explanation: Higher operative rank (reflecting experience) was significantly associated with survival (p < .05).
In Brockman 2025 et al., on canine mitral valve repair outcomes, how did survival change from the first to the last quartile of surgical experience?

A. Remained constant
B. Decreased slightly
C. Fluctuated without pattern
D. Increased from 67% to 91%
E. Increased then decreased

Answer: Increased from 67% to 91%

Explanation: Survival improved from 67% in Q1 to 91% in Q4 as experience increased.
In Brockman 2025 et al., on canine mitral valve repair outcomes, what was the most common cause of death in dogs that did not survive?

A. Sepsis
B. Infective endocarditis
C. Arrhythmia
D. Failure to wean from CPB
E. Pulmonary embolism

Answer: Failure to wean from CPB

Explanation: Among 25 non-survivors, the most frequent cause of death was inability to wean from cardiopulmonary bypass.

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