Abstract
Introduction: Balloon valvuloplasty is treatment of choice for dogs with for severe type A pulmonic stenosis (PS), but less successful for dogs with annular hypoplasia, and unsuitable for supravalvular stenosis or cases with a circumpulmonary coronary malformation. We report outcome and complications of the first 15 consecutive transvalvular pulmonic stent angioplasty (TPSA) procedures performed by a single center in dogs with PS.
Animals, materials and methods: Fifteen dogs with naturally occurring PS. Dogs
underwent echocardiography before and four weeks after the procedure. Transvenous approaches were used to deploy a pre-mounted, balloon expandible metallic stent in all cases.
Results: Of 15 dogs, all had annular hypoplasia, and in addition supravalvular stenosis was diagnosed in 11/15 dogs, and three had R2A coronary malformation. All dogs survived to discharge. One dog died less than four weeks post-operatively (noncardiac) but 14/15 were re-examined at four weeks. Severity reduced in all cases; median pressure gradient reduced from 137 mmHg (range 81-202 mmHg) to 83mmHg (range 31-155 mmHg). Clinical signs improved in all cases and haematocrit reduced in all dogs with erythrocytosis. Median follow-up time was 280 days (range 95-896 days). One year follow up was available in six of fifteen dogs. Two died because of refractory right-sided congestive heart failure signs; one at 10 months and one at 22 months post-operatively.
Conclusions: Transvalvular pulmonic stent angioplasty technique was associated with an improvement in clinical signs and reduction in stenosis severity for all dogs in this population, including cases with supravalvular PS or
circumpulmonary coronary malformation.
Animals, materials and methods: Fifteen dogs with naturally occurring PS. Dogs
underwent echocardiography before and four weeks after the procedure. Transvenous approaches were used to deploy a pre-mounted, balloon expandible metallic stent in all cases.
Results: Of 15 dogs, all had annular hypoplasia, and in addition supravalvular stenosis was diagnosed in 11/15 dogs, and three had R2A coronary malformation. All dogs survived to discharge. One dog died less than four weeks post-operatively (noncardiac) but 14/15 were re-examined at four weeks. Severity reduced in all cases; median pressure gradient reduced from 137 mmHg (range 81-202 mmHg) to 83mmHg (range 31-155 mmHg). Clinical signs improved in all cases and haematocrit reduced in all dogs with erythrocytosis. Median follow-up time was 280 days (range 95-896 days). One year follow up was available in six of fifteen dogs. Two died because of refractory right-sided congestive heart failure signs; one at 10 months and one at 22 months post-operatively.
Conclusions: Transvalvular pulmonic stent angioplasty technique was associated with an improvement in clinical signs and reduction in stenosis severity for all dogs in this population, including cases with supravalvular PS or
circumpulmonary coronary malformation.
| Original language | English |
|---|---|
| Pages (from-to) | 1-11 |
| Number of pages | 11 |
| Journal | Journal of Veterinary Cardiology |
| Volume | 38 |
| Early online date | 24 Sept 2021 |
| DOIs | |
| Publication status | Published - 1 Dec 2021 |
Bibliographical note
Funding Information:The authors would like to thank Dr Graham Derrick of Great Ormond Street Children's Hospital for his advice on our early case selection.
Publisher Copyright:
© 2021 Elsevier B.V.
Keywords
- Interventional cardiology
- Congenital heart disease
- Cardiology