A pilot study evaluating cutting and high-pressure balloon valvuloplasty for dysplastic pulmonary valve stenosis in 7 dogs
Autor: | Brian A. Scansen, Lauren E. Markovic |
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Rok vydání: | 2019 |
Předmět: |
Balloon Valvuloplasty
Male medicine.medical_specialty 040301 veterinary sciences Physiology Pulmonic stenosis Heart Valve Diseases Hemodynamics Pilot Projects 030204 cardiovascular system & hematology Balloon 0403 veterinary science 03 medical and health sciences 0302 clinical medicine Dogs Restenosis Internal medicine medicine Animals Dog Diseases Prospective Studies General Veterinary business.industry 04 agricultural and veterinary sciences medicine.disease Stenosis medicine.anatomical_structure Echocardiography Cardiology Female Cutting balloon business Transpulmonary pressure Artery |
Zdroj: | Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology. 25 |
ISSN: | 1875-0834 |
Popis: | Introduction This case series describes early experience and technical aspects of cutting balloon dilation followed by high-pressure balloon pulmonary valvuloplasty in dogs with dysplastic pulmonary valve stenosis. Animals Seven client-owned dogs were enrolled in this study. Methods Dogs were prospectively enrolled based on echocardiographic diagnosis of severe pulmonary valve dysplasia, defined as marked valve thickening with variable degrees of annular hypoplasia or subvalvar fibrous obstruction and a peak echocardiography-derived transpulmonary pressure gradient higher than 100 mmHg. Preinterventional and postinterventional hemodynamic data and transthoracic pressure gradients were obtained for all dogs. Recheck echocardiography varied in timing by client convenience, with maximum follow-up 35 months after intervention. Results No intraprocedural or periprocedural mortality was observed. The only major complication was partial avulsion of a cutting blade related to exceeding recommended burst pressure of the device, which was not associated with obvious clinical consequence. Invasive hemodynamic measurements demonstrated an average reduction of 46% in peak systolic right ventricular-to-pulmonary artery pressure gradient (range, 31–77%). The echocardiographic results 24 h after procedure demonstrated an average reduction in pressure gradient of 43% (range, 20–66%), with late follow-up demonstrating an average reduction of 35% (range, 10–57%) compared with preprocedural echocardiography. Conclusions This procedure is a feasible therapeutic transcatheter intervention for dogs with dysplastic pulmonary valves and appears safe in this small cohort. The ideal selection criteria and rate of restenosis for this procedure is under investigation, and long-term follow-up and a large, randomized, controlled study are necessary to demonstrate efficacy. |
Databáze: | OpenAIRE |
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