Introduction

Balloon valvuloplasty is the treatment of choice for dogs with 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 outcomes and complications of the first 15 consecutive transvalvular pulmonic stent angioplasty procedures performed by a single center in dogs with PS.

Animals

Fifteen dogs with naturally occurring PS were included in the study.

Materials and methods

Dogs underwent echocardiography before and four weeks after the procedure. Transvenous approaches were used to deploy a pre-mounted, balloon-expandable metallic stent in all cases.

Results

Of 15 dogs, all had annular hypoplasia, and in addition, supravalvular stenosis was diagnosed in 11 of 15 dogs, and three had R2A coronary malformation. All dogs survived to discharge. One dog died less than four weeks postoperatively (non-cardiac), but 14 of 15 dogs were re-examined at four weeks. Severity reduced in all cases; median pressure gradient reduced from 137 mmHg (range 81–202 mmHg) to 83 mmHg (range 31–155 mmHg). Clinical signs improved in all cases, and hematocrit reduced in all dogs with erythrocytosis. The median follow-up time was 280 days (range 95–896 days). Over one-year follow-up was available in six of fifteen dogs. Two dogs died because of refractory right-sided congestive heart failure signs: one at 10 months and one at 22 months postoperatively.

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.

中文翻译：

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经瓣肺动脉支架血管成形术：15 只肺动脉狭窄犬的手术结果和并发症

介绍

球囊瓣膜成形术是严重 A 型肺动脉狭窄 (PS) 犬的首选治疗方法，但对于瓣环发育不全且不适合瓣上狭窄或肺周围冠状动脉畸形的犬则不太成功。我们报告了由单一中心对 PS 犬进行的前 15 次连续跨瓣肺支架血管成形术的结果和并发症。

动物

研究中包括了 15 只具有天然 PS 的狗。

材料和方法

狗在手术前和手术后 4 周接受了超声心动图检查。在所有情况下，都使用经静脉方法来部署预先安装的球囊扩张金属支架。

结果

在 15 只狗中，所有狗都有环状发育不全，此外，15 只狗中有 11 只被诊断出瓣膜上狭窄，其中 3 只患有 R2A 冠状动脉畸形。所有的狗都存活了出院。一只狗在术后不到 4 周内死亡（非心脏），但 15 只狗中有 14 只在 4 周时重新检查。在所有情况下都降低了严重程度；中值压力梯度从 137 mmHg（范围 81-202 mmHg）降至 83 mmHg（范围 31-155 mmHg）。所有病例的临床症状均有改善，所有红细胞增多症犬的血细胞比容均降低。中位随访时间为 280 天（范围 95-896 天）。15 只狗中有 6 只进行了一年以上的随访。两只狗因顽固性右侧充血性心力衰竭体征死亡：一只在术后 10 个月，另一只在术后 22 个月。

结论

跨瓣肺支架血管成形术技术与该人群中所有犬的临床症状改善和狭窄严重程度降低有关，包括瓣上 PS 或肺周围冠状动脉畸形的病例。