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ORIGINAL RESEARCH article

Front. Vet. Sci.
Sec. Veterinary Surgery
Volume 11 - 2024 | doi: 10.3389/fvets.2024.1448828

Clinical Feasibility Study of Transcatheter Edge-to-Edge Mitral Valve Repair in Dogs with the Canine Mitral V-Clamp Device

Provisionally accepted
Brianna M Potter Brianna M Potter *E Christopher Orton E Christopher Orton Brian A Scansen Brian A Scansen Katie M Abbott-Johnson Katie M Abbott-Johnson Lance C Visser Lance C Visser I-Jung B Chi I-Jung B Chi Evan S Ross Evan S Ross Bruna Del Nero Bruna Del Nero Lalida Tantisuwat Lalida Tantisuwat Ellen T Krause Ellen T Krause Marlis L Rezende Marlis L Rezende Khursheed Mama Khursheed Mama
  • Colorado State University, Fort Collins, United States

The final, formatted version of the article will be published soon.

    Objective: To determine procedural feasibility, safety, and short-term efficacy in dogs with severe degenerative mitral regurgitation (MR) undergoing transcatheter edge-to-edge repair (TEER) with a canine-specific device. Design: Prospective, single-arm (uncontrolled), single-institution clinical feasibility study Animals: Fifty client-owned dogs with severe degenerative MR operated over a 28-month period Methods: TEER was performed using the canine mitral V-Clamp via a transapical approach using transesophageal echocardiographic and fluoroscopic guidance. Indices of MR severity were determined by echocardiography the day before and 2 to 3 days after the procedure. Results: Procedural feasibility was 96% based on delivery of at least one device in 48 of 50 dogs. There were no procedural deaths. Procedural safety was 96% based on survival to hospital discharge in 48 of 50 dogs. Euthanasia in 2 dogs prior to hospital discharge was due to damage of the mitral valve and worsened MR after the procedure. Device-related adverse event rate was 6.3% based on 3 events (single-leaflet device detachment, locking failure, locking failure with device embolization) in 59 implanted devices. All three events were nonfatal and successfully treated with a second device. Median regurgitant volume (mL/kg) decreased (p<0.001) from 2.3 [1.9, 3.1] to 1.1 [0.3, 1.8]. Median effective regurgitant orifice area (cm2/m2) decreased (p<0.001) from 0.60 [0.40, 0.80] to 0.25 [0.10, 0.50]. Conclusion and clinical importance: Initial feasibility results support continued development of TEER as a procedurally feasible, relatively low-risk, and low morbidity treatment for degenerative MR in dogs. Operator experience and case selection are likely to be important components of success of this technique. Evidence of short-term efficacy is promising but needs to be verified with longer-term follow up.

    Keywords: Mitral regurgitation, Degenerative mitral valve disease, Myxomatous mitral valve disease, Transapical intervention, transcatheter mitral valve repair

    Received: 14 Jun 2024; Accepted: 05 Nov 2024.

    Copyright: © 2024 Potter, Orton, Scansen, Abbott-Johnson, Visser, Chi, Ross, Del Nero, Tantisuwat, Krause, Rezende and Mama. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Brianna M Potter, Colorado State University, Fort Collins, United States

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