A fatal complication arising during pulmonic balloon valvuloplasty in a seven-month-old female bulldog

A seven-month-old female bulldog with severe valvular pulmonic stenosis and ventricular septal defect presented for general anaesthesia for repeat balloon valvuloplasty. The first balloon valvuloplasty procedure was not successful. The second balloon valvuloplasty was effective but was associated with cardiovascular collapse, which was unresponsive to atropine and epinephrine administration and progressed to asystole. Cardiopulmonary resuscitation was unsuccessful. Anaesthetic management of dogs undergoing balloon valvuloplasty is challenging. Selection of anaesthetic technique must consider existing cardiac pathology, common intraprocedural and postprocedural complications and their management options. This case report describes a fatal intraoperative complication of balloon valvuloplasty unresponsive to anticholinergic and sympathomimetic treatment and discusses potential aetiologies of the complication and reasons for treatment failure.