Cardiac surgery insights: Palliative vs. definitive procedures

Ahead of his upcoming lectures at dvm360's Fetch Charlotte conference this weekend, Brian J. Sutherland, DVM, DACVS-SA, explained the differences between a palliative procedure and definitive procedure. Throughout the interview, he uses an example of how the different methods could be used to treat the same condition, and the benefits of each.

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Below is a transcript of the interview.

Brian J. Sutherland, DVM, DACVS-SA: Yeah, sure. Well, my name is Brian Sutherland, small animal surgeon, soft tissue focus at the University of Georgia. I got my my degree from North Carolina State University and my internship at Michigan State and did a surgery specialty internship at Dallas Veterinary Surgical, did my surgery residency at the University of Wisconsin at Madison. I spent my first couple of years after residency in private practice in Northern Virginia, sort of outside of DC, and ended up going back to do a fellowship in cardiac surgery at Colorado State University in 2018 and since then, my sort of energy and sort of interest and focus has been in the realm of cardiac surgery. Outside of work I love mountain biking. We have a small little hobby farm with a bunch of goats and things like that. So that's been a fun, a fun adventure here lately. So yeah, that's, that's me.

So a palliative procedure, generally, is one that I would describe as something that we use to try to mitigate clinical signs for as long as possible, but we're not actually addressing the primary lesion. And so, for example... a patient with a condition called tetralogy of fallot has multiple different congenital heart defects, but a palliative procedure that we can do can reroute some piping and bring more blood to the lungs than the heart is able to provide. And so we can decrease their clinical signs, or maybe completely eliminate those clinical signs, but we're not actually addressing the primary lesion that's causing the problem.

So for a definitive repair, you know, would be doing just a surgical procedure to primarily address the the main problems associated with that cardiac defect. So for the tetralogy of fallot, for example, closing the defect in the ventricular septum and treating the stenosis of the of the pulmonary valve. So, you know... with a definitive repair, generally, the idea is hopefully this is essentially a cure. You know, obviously things always come with some risk and that sort of thing. But sort of palliative is, hey, let's make them feel better for as long as we can. And definitive repairs, hey, let's, you know, attempt to cure, restore normal to your normal expectancy and quality of life.

Want to hear Sutherland and other amazing faculty members at Fetch Charlotte? There is still time to register! Learn more about Fetch Charlotte and secure your spot here today! For those who cannot make it, the dvm360 editorial team will be on-site to provide you real time coverage of sessions, interviews, and more! You can follow along with the dvm360 team's coverage of Fetch Charlotte here.