Balloon Valvuloplasty in 30 Dogs with Pulmonic Stenosis: Effect of Valve Morphology and Annular Size on Initial and 1-Year Outcome

Abstract

Case records of 30 dogs in which valvular pulmonic stenosis (PS) was treated by balloon dilation were reviewed retrospectively. Physical examination, thoracic radiographs, 9-lead ECG, echocardiography, and Doppler studies were performed in all dogs. Two-dimensional and Doppler echocardiography were repeated after 24 h and 1 year after treatment. Dogs were divided into 2 groups based on their valvular anatomy on echocardiography and aortic : pulmonary ratio: 18 had type A PS with normal annulus diameter and aortic : pulmonary ratio 1.2, and 12 had type B PS with pulmonary annulus hypoplasia and aortic : pulmonary ratio 1.2. Most dogs in the type B group were brachycephalic and had no poststenotic dilatation on thoracic radiographs. Of the dogs with type A stenosis, 100% survived valvuloplasty with resolution of clinical signs. At 1-year follow-up, 94.4% were still alive and remained asymptomatic. Of those with type B stenosis, 66.6% had favorable outcome postvalvuloplasty. At 1-year follow-up, 66.6% of dogs were alive, and resolution of clinical signs was obtained in 50%. This study revealed the immediate and long-term efficacy of balloon valvuloplasty in dogs with PS.

Balloon Valvuloplasty for Treatment of Pulmonic Stenosis in English Bulldogs with an Aberrant Coronary Artery

“…Diameters of aortic (Ao) and pulmonary annuli were measured as reported by Bussadori et al 7,8 The pulmonic valves were examined from multiple angles to determine the anatomic structure. The Ao sinus was closely examined to identify presence of 1 or 2 CA ostia.…”

“…The method of angiography was similar to that published. 6,7,13 Briefly, an introducer was placed into the left femoral artery or into the right carotid artery (dog 4) and a pigtail catheter a was placed at the Ao annulus under fluoroscopic guidance. Magnification of the fluoroscopic image was calculated by measuring the distance between the 1 cm markers on this catheter as it sat in the descending Ao, to enable accurate mensuration of angiographic images.…”

“…BV is successful in 100% animals with Type A PS with a reduction of pressure gradients (PG) of 60% and in 66% of dogs with Type B PS achieving a reduction of PG of 48%. 6,7 Type B PS have a higher case fatality rate during procedure and are more likely to have recurrence of stenosis. 7 Aberrant CA are a contraindication for BV, as diminished coronary blood flow or avulsion of the CA can result in death of the dog.…”

“…6,7 Type B PS have a higher case fatality rate during procedure and are more likely to have recurrence of stenosis. 7 Aberrant CA are a contraindication for BV, as diminished coronary blood flow or avulsion of the CA can result in death of the dog. 5,6,8 Therefore, EB which frequently have aberrant CA are usually excluded from BV.…”

Surgical Correction of Pulmonic Stenosis Using Transventricular Pulmonic Dilation Valvuloplasty (Brock) in a Dog

“…It was seemed that surgical intervention using a cardiac catheter or cardiopulmonary bypass was difficult to be performed because of its low body weight [2] and the severity of PS [1,4,7]. Therefore, transventricular pulmonic dilation valvuloplasty (Brock method) was planned when the dog grows up.…”