Balloon valvuloplasty in two dogs with aortic valve stenosis showing congestive heart failure

A 10-year-old female Papillon and a 1-year-old male Golden Retriever were presented to the Tokyo University of Agriculture and Technology for a second opinion on an aortic valve stenosis (AS). The aortic flow rate was not as high as it should have been (the aortic flow velocity for case 1 and case 2 was 2.82 m/s and 3.96 m/s, respectively). However, the AS was suspected to be an exacerbating factor in the congestive heart failure, so that a balloon valvuloplasty was conducted. As a result, the congestion and clinical symptoms were much improved in both cases. In conclusion, in cases with an AS, in which afterload is a key factor for the exacerbation of the congestion, a balloon aortic valvuloplasty may reduce the afterload and consequently lead to an improvement in the congestion.

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Balloon Aortic Valvuloplasty Might Be a Safe Therapeutic Option for Acute Decompensated Heart Failure Due to Severe Aortic Valve Stenosis

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2017.08.086 ◽

2017 ◽

Vol 23 (10) ◽

pp. S22 ◽

Cited By ~ 1

Author(s):

Saaya Fuda ◽

Tsuyoshi Takada ◽

Hiroki Saito ◽

Hiroyuki Satake ◽

Hironori Kanemitsu ◽

...

Keyword(s):

Heart Failure ◽

Aortic Valve ◽

Aortic Valve Stenosis ◽

Acute Decompensated Heart Failure ◽

Therapeutic Option ◽

Decompensated Heart Failure ◽

Balloon Aortic Valvuloplasty ◽

Aortic Valvuloplasty

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Percutaneous balloon aortic valvuloplasty (BAV) as a bridge to surgical aortic valve (SAVR) replacement in patients with severe aortic stenosis presenting with congestive heart failure

Heart Lung and Circulation ◽

10.1016/j.hlc.2014.12.051 ◽

2015 ◽

Vol 24 ◽

pp. e23

Author(s):

A. El-Gamel ◽

N. Kejriwal ◽

Rajesh Nair ◽

S. Pasupati

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Aortic Valve ◽

Aortic Stenosis ◽

Severe Aortic Stenosis ◽

Balloon Aortic Valvuloplasty ◽

Percutaneous Balloon ◽

Aortic Valvuloplasty

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Abstract 19440: Reintervention Rates Following Balloon Aortic Valvuloplasty versus Surgical Valve Repair in Isolated Congenital Aortic Valve Stenosis - A Meta-analysis

Circulation ◽

10.1161/circ.132.suppl_3.19440 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

May T Saung ◽

Courtney McCracken ◽

Ritu Sachdeva ◽

Christopher J Petit

Keyword(s):

Aortic Valve ◽

Aortic Stenosis ◽

Aortic Valve Stenosis ◽

Meta Analysis ◽

Valve Repair ◽

Balloon Aortic Valvuloplasty ◽

Congenital Aortic Stenosis ◽

Primary Indication ◽

Aortic Valvuloplasty

Introduction: The optimal treatment for congenital aortic stenosis (AS) is debated despite decades of experience with both balloon aortic valvuloplasty (BAV) and surgical aortic valve repair (SAV). While BAV has been the mainstay of therapy for AS, recent single-center reports suggest optimal results following SAV. Hypothesis: We propose that reintervention rates following SAV and BAV are equivalent. Methods: We queried Medline, EMBASE and Web of Science for eligible studies using the keywords: “congenital aortic stenosis”, “balloon valvotomy”, “aortic valve stenosis surgery” and “treatment outcome or reintervention”. Studies were excluded when cohort size was <20 pts, when follow-up was < 2.5 yrs from primary intervention, and when primary indication was not AS (e.g. SAV in the setting of aortic valve regurgitation (AR)). Outcomes analyzed included death, reintervention and moderate or severe AR. Analysis was performed using Comprehensive Meta Analysis v3 using random effects models. Results: A total of 20 studies were included in our meta-analysis: SAV alone (n=3), BAV alone (n=12), and both (n=5). The mean age at BAV was 3.1 years (range, 4 days - 7 years) with a mean follow-up duration of 6.8 years, while mean age at SAV was 2.8 years (range, 14.2 days - 7.1 years) with a mean follow-up duration of 9.1 years. Mortality rates following BAV and SAV were 12.3% (95% CI: 7.7 - 19.1) and 10.2% (95% CI: 7.0 - 14.5), respectively (p=0.27). Reintervention following initial procedure for treatment of AS was higher following BAV (35.7% [95% CI: 29 - 43.1]) compared to SAV (25.2% [95% CI: 19.9 - 31.3])(p=0.012). Long-term and mid-term follow-up in these studies showed moderate to severe AR was present in 24.1% and 28.1% of BAV and SAV patients, respectively. Conclusions: Notwithstanding publication bias, both survival rates and development of late AR following BAV and SAV are similar. However, reintervention rates are significantly higher following BAV compared to SAV.

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