Lady Blitz had her follow-up scope by Dr. Madison (who performed her surgery) on Friday morning at Wavertree and it was unfortunately discovered that her tie-back has failed.
Dr. Madison said, “The tie-back sutures cutting through the cartilage resulting in loss of abduction of the arytenoid is the single biggest problem that has plagued this procedure for 50 years.”
We are now left with three options for Lady Blitz: 1) repeat the tie-back surgery; 2) an arytenoidectomy; or 3) a career change.
According to Dr. Madison, about 50% of the horses that undergo a repeat tie-back are still unable to achieve any abduction or adequate abduction after the second surgery, so it’s certainly not a guaranteed fix (nor was the first surgery). Repeat tie-back surgery does, however, offer the best prognosis for the horse being able to perform to her ability if the procedure is successful. An arytenoidectomy (removing the left arytenoid) can be attempted, but the two potential problems with that procedure are possible dynamic collapse of the unsupported soft tissues at high air flows and potential aspiration. The overall success rate in Thoroughbreds following an arytenoidectomy is 50%, meaning 50% will race following the procedure and 50% will have to move on to a second career. Of the 50% that race, some do well and others race but probably not to their full capability. The final option would be exploring broodmare or other second career options.
We will be having further conversations with Dr. Berk (MyRacehorse Resident Veterinarian), who is familiar with this specific case, before making any decisions, but wanted to share the latest with you all.