title: Pulmonic stenosis in dogs: survival and risk factors in a retrospective cohort of patients.
abstract: OBJECTIVE
  To assess survival and risk factors in dogs with pulmonic stenosis.
  
  
  METHODS
  A retrospective review of medical case records of all cases of pulmonic stenosis >50 mmHg, undergoing pulmonary balloon valvuloplasty or not. Survival curves and multivariate analysis were calculated in the overall population and in subgroups.
  
  
  RESULTS
  One hundred and seventy-two cases were included. Factors negatively affecting survival were clinical signs [hazard ratio (HR) 3 · 44, P < 0 · 001], younger age at diagnosis (HR 3 · 96, P = 0 · 001) and valve morphology type B (HR 3 · 33, P = 0 · 001) in the overall population. In those that had pulmonary balloon valvuloplasty group only clinical signs was significant (HR 3 · 44, P < 0 · 001). In cases that did not undergo pulmonary balloon valvuloplasty group Doppler gradient (HR 1 · 02, P < 0 · 001), clinical signs (HR 5 · 41, P = 0 · 002), valve morphology type B (HR 10 · 20, P = 0 · 001) and younger age at diagnosis (HR 12 · 82, P < 0 · 001) negatively affected survival. Dogs with severe pulmonic stenosis undergoing pulmonary balloon valvuloplasty (HR 0 · 47, P = 0 · 047) and asymptomatic dogs with moderate pulmonic stenosis (HR 0 · 10, P = 0 · 042) had a better outcome. Younger age at diagnosis was correlated with poorer outcome in right-sided congestive heart failure dogs (HR 14 · 02, P = 0 · 01).
  
  
  CONCLUSIONS
  Clinical signs, valve morphology type B and age at diagnosis are risk factors in pulmonic stenosis patients. Pulmonary balloon valvuloplasty is a reasonable treatment choice in dogs with severe pulmonic stenosis.
authors.affiliation: Dipartimento di Scienze Veterinarie e Salute Pubblica, Università degli Studi di Milano, via Celoria 10, 20133, Milano, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Locatelli
authors.forename: I
authors.initials: I
authors.lastname: Spalla
authors.forename: O
authors.initials: O
authors.lastname: Domenech
authors.forename: E
authors.initials: E
authors.lastname: Sala
authors.forename: P G
authors.initials: PG
authors.lastname: Brambilla
authors.forename: C
authors.initials: C
authors.lastname: Bussadori
mesh_terms: D000367:Age Factors; D000818:Animals; D004283:Dog Diseases / Q000209:etiology / Q000401:mortality*; D004285:Dogs; D005260:Female; D053208:Kaplan-Meier Estimate; D008297:Male; D016016:Proportional Hazards Models; D011664:Pulmonary Valve / Q000473:pathology; D011666:Pulmonary Valve Stenosis / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000662:veterinary*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis