Pulmonary valve sinus aneurysm associated with pulmonic stenosis and patent ductus arteriosus in a dog.

Advanced imaging is essential when evaluating dogs with pulmonic stenosis for rare concurrent anomalies like pulmonary valve sinus aneurysm.

This case report describes a rare combination of congenital cardiac defects in a 3-year-old neutered female Bernese Mountain Dog, including type A pulmonic stenosis (PS), a pulmonary valve sinus aneurysm (PVSA), and a concurrent left-to-right shunting patent ductus arteriosus (PDA). Transthoracic echocardiography identified classic features of type A PS: normal pulmonary valve annulus, elevated transvalvular pressure gradient, systolic doming of thickened and fused valve leaflets, and concentric right ventricular hypertrophy. A focal aneurysmal dilation originating from the intermediate pulmonary valve leaflet was additionally identified—a finding rarely reported in veterinary medicine. Computed tomography (CT) provided confirmatory anatomic detail, demonstrating pulmonic valve thickening, sinotubular junction narrowing, and a thin-walled, contrast-enhancing saccular dilation arising from the intermediate pulmonary valve sinus. PVSA is an uncommon anomaly in both human and veterinary patients and may carry risks of rupture, thromboembolism, or compression of adjacent structures. The concurrent PDA contributed a left-to-right shunt, further complicating the hemodynamic profile. This case highlights the importance of advanced multimodal cardiac imaging, particularly CT angiography, as a complement to echocardiography in characterizing complex congenital cardiac malformations. Clinicians evaluating dogs with PS should maintain awareness of co-occurring structural anomalies, including rare entities such as PVSA, that may influence prognosis and therapeutic planning.

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