J Vet Sci.  2017 Mar;18(1):111-114. 10.4142/jvs.2017.18.1.111.

Balloon dilation of congenital supravalvular pulmonic stenosis in a dog

• Treseder J
• Jung S

• KMID: 2412596
• DOI: http://doi.org/10.4142/jvs.2017.18.1.111

Abstract

Percutaneous balloon valvuloplasty is considered the standard of care for treatment of valvular pulmonic stenosis, a common congenital defect in dogs. Supravalvular pulmonic stenosis is a rare form of pulmonic stenosis in dogs and standard treatment has not been established. Although, there have been reports of successful treatment of supravalvular pulmonic stenosis with surgical and stenting techniques, there have been no reports of balloon dilation to treat dogs with this condition. Here, a case of supravalvular pulmonic stenosis diagnosed echocardiographically and angiographically in which a significant reduction in pressure gradient was achieved with balloon dilation alone is presented.

Keyword

angiography; pulmonary valve stenosis; transluminal coronary balloon dilation

MeSH Terms

Angioplasty, Balloon/*veterinary
Animals
Coronary Angiography/veterinary
Dog Diseases/congenital/diagnostic imaging/*surgery
Dogs
Echocardiography/veterinary
Male
Pulmonary Valve Stenosis/congenital/diagnostic imaging/surgery/*veterinary

Figure

• 

  Fig. 1 Right parasternal short axis echocardiogram showing the right ventricular outflow tract (RVOT) and main pulmonary artery (PA). (A) The supravalvular lesion (yellow arrowhead) is distal to the pulmonary valve (blue arrow). (B) Color flow Doppler ultrasound shows turbulence originating at the level of the supravalvular stenosis.

• 

  Fig. 2 Fluoroscopic images obtained before and during balloon dilation. (A) Right ventricular angiogram showing the pulmonary valve (blue arrow) and supravalvular pulmonic stenosis (yellow arrowhead). (B) Inflation of the balloon with diluted contrast solution across the stenotic lesion showing a discrete waist (yellow arrowhead) at the level of the supravalvular stenosis. (C) After full inflation of the balloon, complete loss of the waist is noted.

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  Fig. 3 Cranial transverse transesophageal echocardiogram of the right ventricular outflow tract. (A) Continuous wave Doppler across the right ventricular outflow tract prior to balloon dilation showing a peak pressure gradient of 90.87 mmHg. (B) Continuous wave Doppler across the right ventricular outflow tract after balloon dilation showing a decreased-peak pressure gradient of 46.38 mmHg.

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