Pulmonary Valve Stenting in Canine PS: Lessons Learned from 30 Cases (Interactive Session)

For decades, balloon dilation of the pulmonary valve has been the dominant treatment strategy for pulmonary valve stenosis (PS). However, canine PS frequently is dysplastic with thickened valves, fibrotic adhesions to the sinotubular junction, and hypoplasia of the pulmonary annulus. These anatomic features limit the success and durability of balloon pulmonary valvuloplasty in some cases. Although discussed in small case reports over the last several years, large experience with stent implantation in the pulmonary position of dogs has not been described. The author has performed over 30 cases of pulmonary valve stent implantation both in native disease and in dogs that failed balloon pulmonary valvuloplasty. This experience has informed the anatomic features that should be considered prior to pursuing stent implantation for PS, the stent design and properties that work best for dogs, and the technical aspects that lead to successful implantation. These lessons learned will be shared using clinical case material.