High-pressure balloon valvuloplasty for severe pulmonary valve stenosis: a prospective observational pilot study in 25 dogs

Balloon valvuloplasty in 2 juvenile alpacas with severe valvular pulmonic stenosis

“…In both alpacas, the maximum balloon diameter was selected based on current recommendations to achieve a balloon-to-annulus ratio (BA) of approximately 1.3 to 1.5, although a more permissive ratio of 1.2 to 1.5 has also been suggested. 5,8,9,14,[16][17][18] The effective BA for cases 1 and 2 were 1.55 and 1.33, respectively. A double-balloon procedure was employed for the former, as achieving the target BA would have required use of a single balloon with a diameter exceeding 20 mm.…”

“…Thus, a double‐balloon technique was selected as the most efficient means of applying sufficient radial force to the PV while limiting hemodynamic disturbances. 16 , 18 When using this approach, the effective balloon diameter is calculated with the equation 0.82(Diameter 1 + Diameter 2), where diameters 1 and 2 refer to each balloon. 17 , 18 The 16 mm balloons that were initially selected for case 2 yielded a BA of 1.2, and resolution of the PV waist was achieved only after converting to a balloon with a BA of 1.33.…”

“…In both alpacas, the maximum balloon diameter was selected based on current recommendations to achieve a balloon‐to‐annulus ratio (BA) of approximately 1.3 to 1.5, although a more permissive ratio of 1.2 to 1.5 has also been suggested 5,8,9,14,16‐18 . The effective BA for cases 1 and 2 were 1.55 and 1.33, respectively.…”

“…Traditional balloons of this size have relatively low rated burst pressures, and protracted periods of inflation and deflation can contribute to systemic hypotension. Thus, a double‐balloon technique was selected as the most efficient means of applying sufficient radial force to the PV while limiting hemodynamic disturbances 16,18 . When using this approach, the effective balloon diameter is calculated with the equation 0.82(Diameter 1 + Diameter 2), where diameters 1 and 2 refer to each balloon 17,18 .…”

Pulmonary stenosis in a dog submitted to valvuloplasty

“…The technique used in the present case, balloon valvuloplasty, is the technique of choice for pulmonary valve stenosis, performed in conjunction with cardiac catheterization, dilating the stenosed area with balloon insufflation (Treseder & Jung, 2017;Belanger et al, 2018). This technique reduces the pulmonary artery pressure gradient from 40 to 60%, improving the clinical signs and in some situations the echocardiographic parameters, as observed in the report, where the thickness of the interventricular septum and the pressure gradient in the pulmonary artery decreased progressively over the years after balloon valvuloplasty (Bussadori et al, 2001;Locatelli et al, 2011;Strickland & Oyama, 2016).…”