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

Background: English Bulldogs (EB) with pulmonic stenosis (PS) sometimes have an aberrant coronary artery (CA) type R2A encircling the pulmonary artery (PA). Balloon valvuloplasty (BV) is treatment of choice for severe PS, but is considered to be contraindicated in dogs with aberrant CA. Hypothesis:...

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Bibliographic Details
Published in:Journal of veterinary internal medicine 2010-03, Vol.24 (2), p.354-359
Main Authors: Fonfara, S., Martinez Pereira, Y., Swift, S., Copeland, H., Lopez-Alvarez, J., Summerfield, N., Cripps, P., Dukes-McEwan, J.
Format: Article
Language:English
Subjects:
Angiography
Animals
Brachycephalic
Catheterization - veterinary
Coronary Vessel Anomalies - veterinary
Dog Diseases - surgery
Dogs
Pulmonary Valve Stenosis - surgery
Pulmonary Valve Stenosis - veterinary
Retrospective Studies
Survival
VTI
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Summary:Background: English Bulldogs (EB) with pulmonic stenosis (PS) sometimes have an aberrant coronary artery (CA) type R2A encircling the pulmonary artery (PA). Balloon valvuloplasty (BV) is treatment of choice for severe PS, but is considered to be contraindicated in dogs with aberrant CA. Hypothesis: Conservative BV in EB with aberrant CA is safe and improves clinical signs and quality of life. Animals: Four client‐owned EB with severe PS were retrospectively reviewed/analysed. Methods: Retrospective study: Case records, echocardiography, BV, and follow‐up investigations of EB diagnosed with severe PS and treated with BV were reviewed. The ratios of PA to aortic (Ao) velocity time integral (VTI) were calculated to assess progression/improvement of PS. Results: An aberrant CA was confirmed on angiography in all EB. Conservative BV was performed, using a balloon of the size of the PA annulus or smaller (0.6–1 × PA annulus size). All dogs survived the procedure, but only a mild reduction in pressure gradient was achieved. There was an improvement in PA to Ao VTI in 3 of 4 dogs (P≤ .017), which were free of evidence of congestive heart failure (CHF) 5, 10, and 15 months after BV. One dog that had right‐sided CHF when BV was performed died due to progressive right‐sided CHF within 3 months. Conclusions: Conservative BV in EB might be safe and might improve quality and quantity of life.
ISSN:0891-6640
1939-1676
DOI:10.1111/j.1939-1676.2009.0458.x