PEARLS AND PITFALLS IN THE TREATMENT OF PULMONIC STENOSIS

摘要

The following summarizes information from the limited published data and the collective experiences from four universities in treating pulmonic valve stenosis using balloon valvuloplasty.One of the first questions regarding balloon valvuloplasty (BV) for dogs with pulmonic stenosis (PS) is when to intervene. Firm guidelines for deciding which animals need to be treated have not been developed. In pediatric cardiology, most interventionalists agree that treatment should be performed in any child with moderate stenosis or a gradient > 50 mmHg. Most veterinary cardiologists would agree that animals with gradients in the severe range should be treated and a recent study showed that due to agreater risk of cardiac death, dogs with a gradient > 60 mmHg may benefit from BV. Reliance on Doppler derived estimates of gradient alone however, may not be sufficient to make a treatment decision. Several other factors should be taken into consideration when making the decision for treatment, such as the degree of RV hypertrophy, presence of clinical signs, and severity of concurrent tricuspid insufficiency.