Journal of Veterinary Cardiology最新文献

The V-Clamp device is a canine-specific mitral valve (MV) implant delivered via transapical access that has been developed for transcatheter edge-to-edge repair in dogs. Transesophageal echocardiography (TEE) is an essential component of successful V-Clamp implantation as it both evaluates patient candidacy for the procedure and directly guides the intervention. A thorough TEE examination provides information on the mechanism of mitral regurgitation, anatomical characteristics of the MV apparatus, localizes the site of regurgitation relative to the MV segments, confirms mitral regurgitation severity, informs device sizing from mitral annular diameter measurements, and determines the leaflet lengths at the landing zone for device delivery. These findings are critical for clinical decision-making and proper device selection. During the procedure, TEE provides real-time visual guidance of device location, leaflet capture, device stability, and after-procedural assessment. This review will describe TEE imaging for MV edge-to-edge repair in dogs based on the experience gained in 130 dogs undergoing V-Clamp implantation. This is an evolving field that will progress with experience in this procedure across multiple institutions.

Introduction/objectives: The aim of the study was to compare the ingredients, doses, potential safety concerns, and marketing of canine combination cardiac (CCC) supplements currently available in the United States for dogs with myxomatous mitral valve disease (MMVD).

Animals, materials and methods: Searches were conducted to identify CCC supplements marketed for MMVD, other cardiac diseases, or cardiac health/support. The companies' official websites were reviewed for details about the ingredients, doses of each ingredient, safety warnings, supporting information, prices, and marketing claims.

Results: At least 147 different active ingredients were included in the 60 CCC supplements that were included in this study. The number of active ingredients in the products ranged from two to 32 (median = seven). Many of the products did not include enough information to determine ingredient doses, but when it could be calculated, very few of the products reached commonly recommended doses of the most frequently included ingredients (taurine, l-carnitine, coenzyme Q10, or omega-3 fatty acids). Potential concerns with product safety or quality were identified.

Study limitations: Data were recorded from official website information and label photographs from companies' official websites, and CCC products were not purchased to review the labels directly. In addition, supplements were not analyzed to verify the companies' claims of active ingredients and their amounts.

Conclusions: These results demonstrate the wide variety of CCC supplements marketed to dogs with MMVD and other cardiac diseases, as well as the large number of ingredients that have potential safety concerns, possible drug-supplement interactions, suboptimal doses, or limited supportive evidence.

Introduction/objectives: Short-term results of mitral transcatheter edge-to-edge repair (TEER) with the canine V-Clamp device have been promising; however, longer-term outcome data are needed. This prospective study evaluated survival and echocardiographic outcomes in dogs with severe mitral regurgitation (MR) following TEER performed at one referral center.

Animals, materials and methods: Dogs in American College of Veterinary Internal Medicine stages B2, C, and D meeting criteria for severe MR were treated by TEER. The procedure was performed via transapical approach and guided by transesophageal echocardiography and fluoroscopy.

Results: One hundred eleven dogs underwent TEER between January 2021 and January 2025. Technical feasibility for placing one clamp was 97.3%, with a single clamp placed in 80 of 108 / (74%) and two clamps placed in 28 of 108 (26%) dogs. In-hospital mortality was 6.3%, and 3-month survival was 86.4%. Freedom from all-cause and cardiac-related mortality was 75% and 80% at one year and 67% and 78% at two years, respectively. Mean (standard deviation) regurgitant fraction decreased from 60.6 (13.3)% to 35 (23)% post procedure and was 30.7 (24.1)% at one year. Normalized left ventricular diastolic dimension decreased from 2.07 (0.24) to 1.84 (0.3) and short-axis left atrial-to-aortic ratio decreased from 2.31 (0.41) to 2.08 (0.45) immediately post procedure; these variables remained decreased at 1.79 (0.28) and 1.94 (0.46), respectively, at 1-year follow-up (P < 0.001).

Study limitations: Follow-up echocardiograms were obtained by multiple centers.

Conclusions: Intermediate outcomes after TEER demonstrated a likely benefit in dogs with severe MR as adjunct to medical therapy. Future goals include improving consistency of MR reduction, decreasing procedural complications through experience and refined case selection, and prospectively comparing to medical therapies.