Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, 1220 Wire Rd, Auburn, AL, 36849, USA.
Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, 1220 Wire Rd, Auburn, AL, 36849, USA.
J Vet Cardiol. 2024 Oct;55:1-8. doi: 10.1016/j.jvc.2024.05.002. Epub 2024 Jun 27.
INTRODUCTION/OBJECTIVES: Dogs with severe pulmonary stenosis (PS) are routinely treated with balloon valvuloplasty. Success and safety of these procedures require an accurate assessment of the pulmonary valve annulus (PVA) diameter for proper balloon catheter selection. PVA diameter is assessed with angiography (PVA-Ang) and transthoracic echocardiography (PVA-TTE), and both may impact procedural planning for balloon valvuloplasty. The objective of this study was to describe the relationship between PVA-Ang and PVA-TTE in dogs with PS.
ANIMALS, MATERIALS AND METHODS: Observational, retrospective study of 59 client-owned dogs. Medical records of dogs diagnosed with PS were reviewed. Images from selective right ventricular angiography and transthoracic echocardiography were reviewed. The PVA diameters were measured at the time of angiography (PVA-Ang) and by a single operator for this study (PVA-TTE). Image quality scores were assigned to echocardiographic images of the PVA based on visualization of PVA margins and valve leaflet hinge points.
In 41/59 (70%) dogs, the diameter of the PVA-Ang was larger than the PVA-TTE, and the (range 0.1 to 8.4 mm) worse echocardiographic image quality, the difference in measurement between modalities increased. Dogs with poor echocardiographic image quality had greater differences (range -7.7 to 8.4 mm) between PVA-Ang and PVA-TTE compared to those with excellent image quality (range -2.2 to 3.8 mm), and the absolute differences between poor (median 2.8 mm, range 1.5-8.4 mm) and excellent (median 1.4 mm, 0.2-3.8 mm) image quality were significant (P=0.005).
Diameters of PVA-Ang are greater than PVA-TTE in most dogs, and these differences are most apparent with worse echocardiographic image quality. These differences may be clinically relevant to interventional procedure planning.
简介/目的：患有严重肺动脉瓣狭窄（PS）的犬通常接受球囊瓣膜成形术治疗。为了确保这些手术的成功和安全，需要准确评估肺动脉瓣环（PVA）的直径，以便选择合适的球囊导管。PVA 直径通过心血管造影（PVA-Ang）和经胸超声心动图（PVA-TTE）进行评估，这两种方法都可能影响球囊瓣膜成形术的手术计划。本研究的目的是描述患有 PS 的犬中 PVA-Ang 和 PVA-TTE 之间的关系。
动物、材料和方法：对 59 只患犬进行观察性、回顾性研究。回顾了诊断为 PS 的犬的病历。回顾了选择性右心室心血管造影和经胸超声心动图的图像。在心血管造影时（PVA-Ang）和本研究中由一名操作人员（PVA-TTE）测量了 PVA 直径。根据 PVA 边缘和瓣叶铰链点的可视化情况，为 PVA 的超声心动图图像分配图像质量评分。
在 41/59（70%）只犬中，PVA-Ang 的直径大于 PVA-TTE（范围为 0.1 至 8.4 毫米），且超声心动图图像质量较差，两种模态之间的测量差异增大。与超声心动图图像质量极好的犬相比（范围为 -2.2 至 3.8 毫米），超声心动图图像质量较差的犬（范围为 -7.7 至 8.4 毫米）之间的测量差异更大，且较差（中位数 2.8 毫米，范围 1.5-8.4 毫米）和极好（中位数 1.4 毫米，0.2-3.8 毫米）的图像质量之间的绝对差异有统计学意义（P=0.005）。
大多数犬的 PVA-Ang 直径大于 PVA-TTE，且随着超声心动图图像质量变差，这种差异更为明显。这些差异可能对介入性手术计划具有临床意义。
