Key result
Surgical correction of subvalvular aortic stenosis using cardiopulmonary bypass reduced the systolic pressure gradient from 90 mmHg to 44 mmHg, though the dog died suddenly 292 days postoperatively.
Why the study?
Does surgical correction using cardiopulmonary bypass improve outcomes in a dog with severe subvalvular aortic stenosis?
Case Report (n=1)
No
Does surgical correction using cardiopulmonary bypass improve outcomes in a dog with severe subvalvular aortic stenosis?
Absolute Event Rate: 44% vs 90%
Surgical correction of subvalvular aortic stenosis in a dog successfully reduced the pressure gradient and temporarily improved symptoms, but did not prevent sudden cardiac death 10 months post-operation.
Surgical correction may offer short-term relief in canine subvalvular aortic stenosis; leaves open whether it prevents sudden death.
A three-month-old male Golden Retriever had symptoms including exercise intolerance, dyspnea and syncope and was diagnosed with subvalvular aortic stenosis. Cardiac catheterization revealed a left ventricular-aortic systolic pressure gradient of 90 mm Hg. Surgical correction of the condition was achieved using cardiopulmonary bypass. The subvalvular fibrous lesion was resected through an aortotomy. The stenosis was dilated from 8.5 mm to 12.0 mm in diameter. Postoperatively the dog was asymptomatic. Seven months after surgery, the pressure gradient decreased to 44 mm Hg. However, after another three months, the dog died suddenly without any premonitory signs. Postmortem examination revealed that pathologic changes caused by increased left ventricular pressure overload were not severe.
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Hirao et al. (2004) conducted a case report in Subvalvular aortic stenosis (n=1). Surgical correction using cardiopulmonary bypass vs. Baseline (preoperative) was evaluated on Left ventricular-aortic systolic pressure gradient (mmHg). Surgical correction of subvalvular aortic stenosis using cardiopulmonary bypass reduced the systolic pressure gradient from 90 mmHg to 44 mmHg, though the dog died suddenly 292 days postoperatively.
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