Hybrid balloon valvuloplasty for management of severe mitral stenosis in four symptomatic,adult dogs |
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| Institution: | 1. Department of Clinical Sciences, College of Veterinary Medicine, Ohio State University, 601 Vernon L. Tharp St, Columbus, OH, 43210, USA;2. Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX, 77843-4474, USA;3. Heart Institute, Children''s Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA, 90027, USA;1. Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Via Tolara di Sopra 50, 40064, Ozzano dell’Emilia, Italy;2. Freelance Veterinary Cardiologist, Italy;3. Department of Veterinary Sciences, University of Parma, Strada del Taglio 10, 43126 Parma, Italy;1. Department of Physics, University of Washington, Seattle, WA 98195, USA;2. Section of Cardiology, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA;3. The Royal Veterinary College, University of London, London, England, UK;1. Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Texas A&M University, 4474 TAMU, College Station, TX 77843-4474, USA;2. Department of Population Health Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Tech, 205 Duck Pond Dr, Blacksburg, VA 24061, USA |
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| Abstract: | Four adult dogs weighing <10 kg presented for the evaluation of severe mitral valve stenosis with clinical signs. Owing to the size of the dogs, a hybrid surgical and interventional approach was utilized for balloon valvuloplasty. A left lateral thoracotomy was performed to allow direct entry through the left atrial wall. Transesophageal echocardiography was utilized for the entirety of the procedure in all dogs, and fluoroscopy was additionally used in two dogs. One dog had mild to moderate intra-operative bleeding from the left atrial wall during the procedure, but no other intra-operative complications were observed. No dogs developed a clinically relevant amount of worsened mitral regurgitation. Based on mitral leaflet mobility and transmitral flow profiles, there was perceived improvement in all four dogs. One dog died 6 h after extubation due to respiratory arrest. The remaining dogs survived to discharge and had resolution of clinical signs at home and discontinuation of heart failure medications. One dog died of an unknown cause at five months and another developed atrial fibrillation, and the owners elected to euthanize at ten months after the procedure. One dog continues to do well six months after the procedure as of the time of this writing. Hybrid balloon valvuloplasty can be a viable management option for small breed dogs with severe mitral stenosis exhibiting clinical signs, and both transesophageal echocardiography and fluoroscopy can be used intra-operatively to assist in successful procedural outcomes. |
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| Keywords: | Congenital Interventional Surgical |
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