Restenosis after balloon valvuloplasty in a dog with pulmonary stenosis

Abstract

A two-month-old female Chihuahua was diagnosed as severe pulmonary valvular stenosis (PS). Although balloon valvuloplasty (BV) was successfully performed, restenosis was observed 19 months after the procedure. Euthanasia was chosen due to low output syndrome during the surgical repair attempted when the dog was 5 years old. Postmortem examination revealed markedly thickened pulmonary valve due to the increase of extracellular matrix which might be produced by increased α smooth muscle actin-positive myofibroblasts. The thickening of the valve was associated with restriction of the valve’s motion, resulting in restenosis in the present case. This is the first case report documented histopathological and immunohistochemical findings of the restenotic pulmonary valve in dogs with PS after BV.

The left ventricular functions and heart rate variability in dogs with pulmonic valvular stenosis

“…In dog clinical report, 6 from 22 dogs developed restenosis at average of 5.5 months (range 1.5-68.2 months) after BV (Sunahara et al, 2014). Other severe complications such as sudden death due to cardiac arrest, rupture of the coronary artery, coronary ischemia, severe hypotension, bleeding, arrhythmias and RBBB had been reported (Johnson et al, 2004;Sunahara et al, 2014).…”

“…Recurrent stenosis in PS patients after BV intervention had been periodically reported, especially in the case that balloon:PV annulus ratio was less than 1.2 or PG after BV was over 30 mmHg (Rao et al, 1988). In dog clinical report, 6 from 22 dogs developed restenosis at average of 5.5 months (range 1.5-68.2 months) after BV (Sunahara et al, 2014). Other severe complications such as sudden death due to cardiac arrest, rupture of the coronary artery, coronary ischemia, severe hypotension, bleeding, arrhythmias and RBBB had been reported (Johnson et al, 2004;Sunahara et al, 2014).…”