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Ryave J, Sanders RA, Gunasekaran T. Successful balloon angioplasty in a cat with unilateral left pulmonary artery branch stenosis. J Vet Cardiol 2023; 50:17-22. [PMID: 37913605 DOI: 10.1016/j.jvc.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 08/25/2023] [Accepted: 09/16/2023] [Indexed: 11/03/2023]
Abstract
A 9-month-old intact male Ragdoll cat was presented for evaluation of a left-sided systolic murmur that was first auscultated during examination for a newly developed cough. Transthoracic echocardiography revealed a narrowed left pulmonary artery and an increase in flow velocities at the level of the narrowing, consistent with left pulmonary artery branch stenosis. The right pulmonary artery appeared normal. Balloon angioplasty was performed and successfully reduced pressure gradient across the stenosis. The patient continues to do well 14 months after the procedure.
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Affiliation(s)
- J Ryave
- Michigan State University College of Veterinary Medicine, 736 Wilson Road, East Lansing, MI 48824, USA
| | - R A Sanders
- Michigan State University College of Veterinary Medicine, 736 Wilson Road, East Lansing, MI 48824, USA.
| | - T Gunasekaran
- BluePearl Pet Hospital, 4126 Packard Road, Ann Arbor, MI 48108, USA
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Chrai GE, Lawson PB, Köster LS. Pulmonary artery stenosis versus supravalvular pulmonic stenosis: Correctly describing a congenital stenosis of the pulmonic outflow tract in a domestic cat. Vet Record Case Reports 2022. [DOI: 10.1002/vrc2.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Gurcharan Emily Chrai
- University of Tennessee College of Veterinary Medicine Knoxville Tennessee USA
- Colorado Animal Specialty and Emergency Boulder Colorado USA
| | - P. Brent Lawson
- University of Tennessee College of Veterinary Medicine Knoxville Tennessee USA
- Veterinary Cardiopulmonary Care Center Pompano Beach Florida USA
| | - Liza S. Köster
- University of Tennessee College of Veterinary Medicine Knoxville Tennessee USA
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Santarelli G, Bouvard J, Brethel SF, Gordon S, Lord S, Mavropoulou A, Oliveira P, Sykes KT, Swift S, Culshaw GJ. Non-cardiogenic pulmonary oedema complicating balloon valvuloplasty and stent angioplasty of severe pulmonary valve stenosis in four dogs. J Vet Cardiol 2021; 39:79-88. [PMID: 34999479 DOI: 10.1016/j.jvc.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 11/15/2021] [Accepted: 12/01/2021] [Indexed: 10/19/2022]
Abstract
In dogs, balloon valvuloplasty is considered the treatment of choice for severe pulmonary valve stenosis, and this technique is currently performed routinely in specialist referral practices with low morbidity and mortality. Stent angioplasty has also been recently proposed as a viable treatment option. The present case series describes the clinical course of four dogs with severe pulmonary valve stenosis, treated with balloon valvuloplasty or stent angioplasty at four different institutions, which developed non-cardiogenic pulmonary oedema perioperatively after apparently successful dilation of the pulmonary valve. In three cases, there was evidence of some degree of pulmonary hypertension before ballooning. Despite intensive care, the complication proved fatal in three cases. Clinicians should therefore be aware of this life-threatening complication, previously undescribed in dogs.
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Affiliation(s)
- G Santarelli
- Cardiopulmonary Service, Hospital for Small Animals, Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Roslin, EH25 9RG, UK.
| | - J Bouvard
- Cardiopulmonary Service, Hospital for Small Animals, Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Roslin, EH25 9RG, UK
| | - S F Brethel
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, 32608, USA
| | - S Gordon
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX, 77843, USA
| | - S Lord
- Anesthesia Service, Roslin, EH25 9RG, UK
| | - A Mavropoulou
- Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hitchin, SG5 3HR, UK
| | - P Oliveira
- Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hitchin, SG5 3HR, UK
| | - K T Sykes
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX, 77843, USA
| | - S Swift
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, 32608, USA
| | - G J Culshaw
- Cardiopulmonary Service, Hospital for Small Animals, Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Roslin, EH25 9RG, UK
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Vezzosi T, Domenech O, Croce M, Pesaresi M, Auriemma E, Romano F, Rondelli V, Tursi M. Fatal acute lung injury after balloon valvuloplasty in a dog with pulmonary stenosis. J Vet Cardiol 2021; 39:8-13. [PMID: 34922143 DOI: 10.1016/j.jvc.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
A one-year-old French Bulldog was referred for the management of a severe form of pulmonary valve stenosis (PS) complicated by right-sided congestive heart failure. Echocardiography showed severe valvular PS with right ventricular concentric hypertrophy, dilatation and severe right atrial enlargement. A pulmonary balloon valvuloplasty (PBV) was performed with a balloon-to-pulmonary annulus ratio of 1.36. Echocardiography immediately after PBV showed a significant reduction in right atrial and ventricular size, improved opening and mobility of the pulmonary valve leaflets, and a 75% reduction in the pulmonary pressure gradient from 158 mmHg pre-operative to 40 mmHg post-operative. The dog recovered well from anesthesia, but 2 h later, it suddenly showed severe respiratory distress. Focus cardiac ultrasound showed increased left cardiac size with echocardiographic signs of high left ventricular filling pressure. Bedside lung ultrasound showed diffuse numerous-to-confluent B lines, compatible with a severe alveolar-interstitial syndrome. The dog was treated with furosemide, helmet continuous positive airway pressure, and then mechanical ventilation but without success. At post-mortem evaluation, histological examination of the lung showed diffuse, severe broncho-alveolar edema with mixed leukocyte, fibrin, and red blood cell infiltrate. Moreover, severe congestion and multifocal alveolar hemorrhages were evident. All findings were compatible with fatal acute lung injury after PBV secondary to pulmonary reperfusion-ischemia injury and increased pulmonary capillary hydrostatic pressure. Based on the present case, acute lung injury should be considered as a rare but serious complication of PBV.
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Affiliation(s)
- T Vezzosi
- Anicura Istituto Veterinario di Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, Novara, Italy; Department of Veterinary Sciences, University of Pisa, Via Livornese lato monte, 56122 San Piero a Grado, Pisa, Italy.
| | - O Domenech
- Anicura Istituto Veterinario di Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, Novara, Italy; Anicura Clinica Veterinaria CMV Varese, Viale Padre P.G. Aguggiari 162, 21100 Varese, Italy
| | - M Croce
- Anicura Istituto Veterinario di Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, Novara, Italy
| | - M Pesaresi
- Anicura Istituto Veterinario di Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, Novara, Italy
| | - E Auriemma
- Anicura Istituto Veterinario di Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, Novara, Italy
| | - F Romano
- Anicura Istituto Veterinario di Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, Novara, Italy
| | - V Rondelli
- Anicura Istituto Veterinario di Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, Novara, Italy
| | - M Tursi
- Department of Veterinary Sciences, University of Turin, Largo Paolo Braccini 2, 10095 Grugliasco, Turin, Italy
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