title: Outcome in 55 dogs with pulmonic stenosis that did not undergo balloon valvuloplasty or surgery.
abstract: OBJECTIVE
  To determine the outcome, independent predictors of cardiac death, and the Doppler-derived pressure gradient cut-off for predicting cardiac death in dogs with pulmonic stenosis, with or without tricuspid regurgitation, that do not undergo balloon valvuloplasty or valve surgery.
  
  
  METHODS
  Review of medical records of two UK referral centres between July 1997 and October 2008 for all cases of pulmonic stenosis that had no balloon valvuloplasty or valve surgery. Inclusion criteria included a diagnosis of pulmonic stenosis; spectral Doppler pulmonic velocity greater than 1·6 m/s; characteristic valve leaflet morphological abnormalities. Exclusion criteria included concurrent significant cardiac defects, including tricuspid dysplasia. Dogs with tricuspid regurgitation were included. Dogs were classified according to Doppler-derived pressure gradients into mild, moderate or severe pulmonic stenosis categories.
  
  
  RESULTS
  Presence of tricuspid regurgitation and severe stenosis were independent predictors of cardiac death. A pulmonic pressure gradient of more than 60 mmHg was associated with 86% sensitivity, and 71% specificity of predicting cardiac death.
  
  
  CONCLUSIONS
  There is an increased probability of cardiac death in those cases which have a pulmonary pressure gradient greater than 60 mmHg and tricuspid regurgitation, though the effect of severity of tricuspid regurgitation on outcome was not measurable because of small sample sizes. These animals might benefit from intervention.
authors.affiliation: Royal (Dick) School of Veterinary Studies, The Roslin Institute, Division of Clinical Veterinary Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian.
authors.forename: A J
authors.initials: AJ
authors.lastname: Francis
authors.forename: M J S
authors.initials: MJ
authors.lastname: Johnson
authors.forename: G C
authors.initials: GC
authors.lastname: Culshaw
authors.forename: B M
authors.initials: BM
authors.lastname: Corcoran
authors.forename: M W S
authors.initials: MW
authors.lastname: Martin
authors.forename: A T
authors.initials: AT
authors.lastname: French
mesh_terms: D000818:Animals; D004283:Dog Diseases / Q000000981:diagnostic imaging / Q000401:mortality*; D004285:Dogs; D015150:Echocardiography, Doppler / Q000662:veterinary; D005260:Female; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D011664:Pulmonary Valve / Q000033:anatomy & histology / Q000502:physiology; D011666:Pulmonary Valve Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000662:veterinary*; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000401:mortality / Q000662:veterinary*