Balloon Valvuloplasty in Dogs Cuts Aortic Gradient in Half—Without Worsening Regurgitation

Balloon Aortic Valvuloplasty for Congenital Aortic Valvar Stenosis in 10 Dogs

R.L. Winter, B.A. Scansen, K.L. Maneval, C.S. Ferrel, B.M. Potter, M.K. Ames, P.-T. Liao, S.W. Jung

Background:
Aortic valvar stenosis (AS) is an uncommon congenital defect in dogs but can cause serious clinical signs including syncope and congestive heart failure. In human medicine, balloon aortic valvuloplasty (BAV) is a widely used intervention, yet its utility in veterinary medicine remains poorly described. This study aimed to describe the procedural technique, echocardiographic characteristics, and short-term outcomes in dogs undergoing BAV for severe congenital AS.

Methods:
This retrospective study analyzed 10 dogs diagnosed with severe AS by echocardiography and angiography across three referral centers. Data collected included echocardiographic parameters, procedural details (e.g., balloon size, use of rapid right ventricular pacing), and post-BAV pressure gradients. The impact of BAV on aortic insufficiency (AI) severity and clinical signs was also evaluated. Follow-up data were obtained for six dogs. Statistical comparisons between pre- and post-procedure values were performed.

Results:
The median age was 12 months, and median weight was 18.2 kg. Balloon-to-annulus ratios averaged 1.03. BAV significantly reduced the maximum systolic pressure gradient across the aortic valve from 183.2 mmHg to 97.4 mmHg (P < 0.001). AI severity remained stable in most cases; three dogs had mild worsening, but none developed severe AI. Clinical signs improved in six of seven dogs with follow-up, though one dog died suddenly four months post-BAV, likely from a ventricular arrhythmia. No major intraoperative complications occurred. At median follow-up of 13 months, pressure gradients remained improved compared to baseline.

Limitations:
The small sample size and retrospective nature of the study limit the generalizability of findings. There was variable long-term follow-up, and not all dogs underwent direct left ventricular pressure measurements. Additionally, this study focused only on short-term outcomes and cannot comment on long-term restenosis or survival.

Conclusions:
Balloon aortic valvuloplasty appears to be a well-tolerated and effective short-term intervention for reducing outflow tract gradients in dogs with severe AS, without inducing severe AI. Though further studies are needed to evaluate long-term efficacy and durability, BAV may be a viable palliative or bridging therapy for selected canine patients.

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