Cutting and high-pressure balloon angioplasty in a dog with concurrent pulmonary valvar and infundibular stenosis

Abstract

A two-year-old, 7.7-kg female spayed Cocker spaniel dog was presented for further evaluation of severe pulmonary stenosis. Transthoracic echocardiography revealed severe concentric hypertrophy and dilation of the right ventricle, and two distinct levels of obstruction were observed. A discrete level of obstruction was observed at the crista supraventricularis. This lesion was hyperechoic and located roughly 11 mm away from the pulmonary annulus. Additionally, pulmonary leaflets were elongated and demonstrated systolic doming. These findings were consistent with concurrent pulmonary valvar and infundibular stenosis. The peak systolic pressure gradient across the pulmonary annulus assessed by continuous-wave Doppler interrogation was 190 mmHg. The following day, pulmonary balloon angioplasty was performed successfully with cutting and high-pressure balloon catheters. The day after intervention, echocardiography revealed that the peak systolic pressure gradient across the pulmonary annulus had decreased to 65 mmHg. This pressure gradient had further decreased to 30 mmHg nine months later.