title: Balloon valvuloplasty for treatment of pulmonic stenosis in English Bulldogs with an aberrant coronary artery.
abstract: BACKGROUND
  English Bulldogs (EB) with pulmonic stenosis (PS) sometimes have an aberrant coronary artery (CA) type R2A encircling the pulmonary artery (PA). Balloon valvuloplasty (BV) is treatment of choice for severe PS, but is considered to be contraindicated in dogs with aberrant CA.
  
  
  OBJECTIVE
  Conservative BV in EB with aberrant CA is safe and improves clinical signs and quality of life.
  
  
  METHODS
  Four client-owned EB with severe PS were retrospectively reviewed/analysed.
  
  
  METHODS
  Retrospective study: Case records, echocardiography, BV, and follow-up investigations of EB diagnosed with severe PS and treated with BV were reviewed. The ratios of PA to aortic (Ao) velocity time integral (VTI) were calculated to assess progression/improvement of PS.
  
  
  RESULTS
  An aberrant CA was confirmed on angiography in all EB. Conservative BV was performed, using a balloon of the size of the PA annulus or smaller (0.6-1 x PA annulus size). All dogs survived the procedure, but only a mild reduction in pressure gradient was achieved. There was an improvement in PA to Ao VTI in 3 of 4 dogs (P < or = .017), which were free of evidence of congestive heart failure (CHF) 5, 10, and 15 months after BV. One dog that had right-sided CHF when BV was performed died due to progressive right-sided CHF within 3 months.
  
  
  CONCLUSIONS
  Conservative BV in EB might be safe and might improve quality and quantity of life.
authors.affiliation: Small Animal Teaching Hospital, University of Liverpool, Leahurst, Chester High Road, Neston CH64 7TE, UK. fonfara@liverpool.ac.uk
authors.forename: S
authors.initials: S
authors.lastname: Fonfara
authors.forename: Y
authors.initials: Y
authors.lastname: Martinez Pereira
authors.forename: S
authors.initials: S
authors.lastname: Swift
authors.forename: H
authors.initials: H
authors.lastname: Copeland
authors.forename: J
authors.initials: J
authors.lastname: Lopez-Alvarez
authors.forename: N
authors.initials: N
authors.lastname: Summerfield
authors.forename: P
authors.initials: P
authors.lastname: Cripps
authors.forename: J
authors.initials: J
authors.lastname: Dukes-McEwan
mesh_terms: D000818:Animals; D002404:Catheterization / Q000662:veterinary*; D003330:Coronary Vessel Anomalies / Q000662:veterinary*; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D011666:Pulmonary Valve Stenosis / Q000601:surgery / Q000662:veterinary*; D012189:Retrospective Studies