Multicenter, retrospective study of balloon valvuloplasty-associated pulmonary artery dissection in dogs with pulmonary valve stenosis

Introduction/Objectives Pulmonary artery dissection (PAD) is a rare complication in dogs with pulmonary valve stenosis (PS) that undergo balloon valvuloplasty (BVP). This study aimed to describe demographic, interventional, and survival data in a cohort of dogs with PS that experienced PAD during BVP. Animals Materials and Methods: Fifty-three dogs were included in this retrospective, multicenter study, with medical records and available stored images reviewed. Results Dogs that developed PAD during BVP had a median body weight of 12.5 kg (range: 1.1-50.7 kg), median age of 0.8 years (range: 0.2-8.1 years), and 30/53 (56.6%) were male. Pit Bull Terriers, Pit Bull Terrier mixes, and “Bully breeds” represented 23/53 dogs in the study (43.4%). Median angiographic balloon diameter to pulmonary valve annulus ratio of the largest balloon utilized during BVP was 1.4 (range: 1.0-1.58). High-pressure balloons (>6 atmospheres) were utilized in 27 dogs (50.9%). Post-BVP transthoracic echocardiographic imaging clearly demonstrated the PAD in 62.2% of dogs, while 90.3% and 84.0% of available post-BVP angiography and transesophageal echocardiographic studies did, respectively. Forty-eight dogs (90.6%) survived to discharge. Median time from BVP to last follow-up or death (if applicable) was 2.0 years (range: 0.2-10.5 years), with all 27 dogs for whom > 1 year of follow-up data was available confirmed alive at that time. Study Limitations Retrospective study design. Conclusions Dogs experiencing PAD during BVP have a high likelihood of survival in the immediate and long-term. Immediate post-BVP imaging with angiography or transesophageal echocardiography appears more sensitive than transthoracic echocardiography for diagnosis of PAD.