Balloon treatment for severe aortic valve narrowing in 10 dogs

Abstract

INTRODUCTION/OBJECTIVES: Aortic valvar stenosis (AS) is an uncommon congenital defect in the dog, but when present, it can cause severe clinical signs including collapse and congestive heart failure. In human patients, AS is a common congenital defect that has been managed with balloon aortic valvuloplasty (BAV). The objectives of this study were to describe the procedural details and retrospectively evaluate the outcomes of dogs with severe AS that underwent BAV. ANIMALS: Ten client-owned dogs diagnosed with severe AS. MATERIALS AND METHODS: Medical records and stored images from echocardiographic and angiographic examinations were reviewed from dogs that were diagnosed with severe AS and underwent BAV. The severity of velocity-derived maximal systolic pressure gradient across the aortic valve and aortic insufficiency was assessed from transthoracic echocardiographic images before and after BAV. Procedural details from the BAV procedures including intra-operative complications, type and size of the balloon catheter used, and use of rapid right ventricular pacing were recorded. RESULTS: The median (range) age and weight at the time of BAV were 12 months (6-120 months) and 18.2 kg (4.8-33.0 kg), respectively. Most dogs had high-pressure balloon dilation catheters used (n = 6/10) during BAV, and the balloon diameter-to-aortic annular ratio was 1.03 &#xb1; 0.05 for all dogs. The maximal systolic pressure gradient across the aortic valve decreased from 183.2 mmHg &#xb1; 74.6 before BAV to 97.4 mmHg &#xb1; 48.2 immediately after BAV (P<0.001). The severity of aortic insufficiency did not significantly worsen after BAV (P=0.25). The long-term impact of BAV on survival is unknown, and this could be considered a limitation of this study. STUDY LIMITATIONS: This study describes the short-term effects of BAV for dogs with AS, and a lack of long-term follow-up may be considered a limitation. CONCLUSIONS: Balloon aortic valvuloplasty for severe AS is tolerated in most dogs, and dogs with severe AS may benefit from transcatheter BAV.