Key result
Pulmonary balloon valvuloplasty is linked to ~53% lower mortality in severe pulmonic stenosis.
Why the study?
Survival and risk factors in dogs with pulmonic stenosis have not been fully characterized, including the impact of pulmonary balloon valvuloplasty.
Cohort (n=172)
Hazard Ratio: 0.47
p-value: p=0.047
Clinical signs and younger age were associated with worse survival in canine pulmonic stenosis; leaves open optimal intervention timing pending prospective data.
OBJECTIVES: To assess survival and risk factors in dogs with pulmonic stenosis. METHODS: A retrospective review of medical case records of all cases of pulmonic stenosis >50 mmHg, undergoing pulmonary balloon valvuloplasty or not. Survival curves and multivariate analysis were calculated in the overall population and in subgroups. RESULTS: One hundred and seventy-two cases were included. Factors negatively affecting survival were clinical signs [hazard ratio (HR) 3 · 44, P < 0 · 001], younger age at diagnosis (HR 3 · 96, P = 0 · 001) and valve morphology type B (HR 3 · 33, P = 0 · 001) in the overall population. In those that had pulmonary balloon valvuloplasty group only clinical signs was significant (HR 3 · 44, P < 0 · 001). In cases that did not undergo pulmonary balloon valvuloplasty group Doppler gradient (HR 1 · 02, P < 0 · 001), clinical signs (HR 5 · 41, P = 0 · 002), valve morphology type B (HR 10 · 20, P = 0 · 001) and younger age at diagnosis (HR 12 · 82, P < 0 · 001) negatively affected survival. Dogs with severe pulmonic stenosis undergoing pulmonary balloon valvuloplasty (HR 0 · 47, P = 0 · 047) and asymptomatic dogs with moderate pulmonic stenosis (HR 0 · 10, P = 0 · 042) had a better outcome. Younger age at diagnosis was correlated with poorer outcome in right-sided congestive heart failure dogs (HR 14 · 02, P = 0 · 01). CLINICAL SIGNIFICANCE: Clinical signs, valve morphology type B and age at diagnosis are risk factors in pulmonic stenosis patients. Pulmonary balloon valvuloplasty is a reasonable treatment choice in dogs with severe pulmonic stenosis.
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Locatelli et al. (2013) conducted a cohort in Pulmonic stenosis (n=172). Pulmonary balloon valvuloplasty vs. No pulmonary balloon valvuloplasty was evaluated on Survival (HR 0.47, p=0.047). Pulmonary balloon valvuloplasty was associated with improved survival in dogs with severe pulmonic stenosis (HR 0.47, P=0.047), whereas clinical signs and younger age negatively affected survival.
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