Background - Pulmonary valve annular (PVA) diameter is assessed with angiography (PVA–Ang) and transthoracic echocardiography (PVA–TTE), and both may impact procedural planning for balloon valvuloplasty in dogs with pulmonary stenosis (PS). Hypothesis/Objectives - The objective of this study was to describe the relationship between PVA–Ang and PVA–TTE in dogs with PS. We hypothesized that echocardiographic image quality would impact level of agreement and that PVA-Ang would be greater than PVA-TTE in most dogs. Animals - Observational, retrospective study of 93 client-owned dogs. Methods - Medical records of dogs with PS were reviewed. PVA diameter was measured on both angiographic (PVA-Ang) and transthoracic echocardiographic (PVA-TTE) images. Image quality scores were assigned to echocardiographic images of the PVA based on visualization of PVA margins and valve leaflet hinge points. Agreement between image modalities was assessed by Bland-Altman analysis, and an ANOVA or Kruskal-Wallis test was used for between-group comparisons. A P value < 0.05 was considered significant. Results- In 70% of dogs, the PVA-Ang was larger than the PVA–TTE. The median difference between measurements was 1.6mm (range 0.0 – 8.4mm). Dogs with poor echocardiographic image quality had greater differences (P < 0.001) between PVA-Ang and PVA-TTE (median 2.7mm, range 1.35 - 8.4mm) compared to those with excellent image quality (median 1.2mm, range 0.1 - 3.8mm). Conclusions and clinical importance – Diameters of PVA–Ang were greater than PVA–TTE in most dogs, which was most apparent with worse echocardiographic image quality. These differences may be clinically relevant to interventional procedure planning.
