Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH, 43220, USA.
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH, 43220, USA.
J Vet Cardiol. 2021 Apr;34:29-36. doi: 10.1016/j.jvc.2020.12.006. Epub 2021 Jan 6.
INTRODUCTION/OBJECTIVES: Pulmonary stenosis (PS) is a common congenital defect in the dog. Severe valvar PS can be treated with balloon valvuloplasty (BV) to reduce obstruction severity and improve clinical signs. Repeat BV is often unnecessary, as restenosis is uncommon. Repeated pulmonary BV in people is generally successful and safe, but outcomes in dogs with recurrent or persistent stenosis have not been reported. The objectives of this study were to retrospectively evaluate outcomes of repeat BV in dogs.
ANIMALS, MATERIALS, AND METHODS: Medical records and stored echocardiographic images were reviewed from dogs that received repeat BV for pulmonary valvar restenosis or persistent stenosis. Echocardiographic variables included maximum systolic ejection velocity (PVmax), velocity-derived maximal pressure gradient (PGmax) and velocity time integral (VTI) across the pulmonary valve, and ratios of pulmonic to aortic maximum velocity (PVmax/AVmax) and VTI (VTI/VTI).
Twenty-three dogs were included; one underwent three BV procedures. The median time between BV procedures was 18.3 months (interquartile range, 6.3-43.6). One dog died during repeat BV, but no others experienced adverse effects. Reductions in PVmax, PGmax, and VTI after initial and repeat BV were 1.85 m/s, 76.2 mmHg, and 44.7 cm and 1.33 m/s, 55.6 mmHg, and 30.2 cm, respectively (all p < 0.01). Differences between pre-BV and post-BV PVmax, PGmax, VTI, PVmax/AVmax, and VTI/VTI were not different comparing initial to repeat BV (all p > 0.10).
Repeat BV for recurrent or persistent PS is well tolerated and effective in a majority of dogs.
介绍/目的：肺动脉瓣狭窄（PS）是犬的一种常见先天性缺陷。严重的瓣下 PS 可以通过球囊瓣膜成形术（BV）治疗，以减轻阻塞程度并改善临床症状。由于再狭窄并不常见，因此通常不需要重复 BV。在人类中，重复进行肺动脉 BV 通常是成功且安全的，但在复发或持续性狭窄的犬中尚未报道其结果。本研究的目的是回顾性评估重复 BV 治疗犬复发性或持续性 PS 的效果。
动物、材料和方法：回顾性分析了因肺动脉瓣再狭窄或持续性狭窄而接受重复 BV 治疗的犬的病历和储存的超声心动图图像。超声心动图变量包括最大收缩期射流速度（PVmax）、速度衍生的最大压力梯度（PGmax）和肺动脉瓣跨瓣速度时间积分（VTI），以及肺动脉瓣与主动脉瓣最大速度比（PVmax/AVmax）和 VTI（VTI/VTI）。
共纳入 23 只犬，其中 1 只犬接受了 3 次 BV 治疗。BV 之间的中位时间为 18.3 个月（四分位距，6.3-43.6）。1 只犬在重复 BV 期间死亡，但无其他犬出现不良反应。初次和重复 BV 后 PVmax、PGmax 和 VTI 分别降低了 1.85 m/s、76.2 mmHg 和 44.7 cm 和 1.33 m/s、55.6 mmHg 和 30.2 cm（均 p < 0.01）。比较初次和重复 BV，PVmax、PGmax、VTI、PVmax/AVmax 和 VTI/VTI 等参数在 BV 前后的差异均无统计学意义（均 p > 0.10）。
在大多数犬中，重复进行复发性或持续性 PS 的 BV 治疗是耐受良好且有效的。
