Keynote Message

Myxomatous mitral valve disease (MMVD) is the most common cardiac disease in dogs, and the principal cause of congestive heart failure (CHF) in this species. Dogs affected by MMVD are currently treated medically in order to control clinical signs of CHF. Although drug therapy was demonstrated to reduce mortality, the underlying cause of clinical signs, mitral regurgitation, is not specifically addressed by medical therapies and the disease is progressive. In humans, standard care of patients with MMVD is surgical mitral valve repair, but the invasiveness, complexity, and high cost of this procedure has limited its implementation in veterinary medicine. Therefore, minimally invasive mitral valve repair/replacement represents an appealing alternative to the open heart surgery in veterinary medicine. In this session, current options for mini-invasively repair or replace the mitral valve will be critically reviewed. Moreover, preliminary results of minimally invasive mitral valve repair performed at our institutions will be discussed.

Key References

1.  Borgarelli M, Lanz O, Pavlisko N, et al. Mitral valve repair in dogs using an ePTFE chordal implantation device: a pilot study. J Vet Cardiol. 2017;19:256–267.

2.  Fam NP, Ross HJ, Verma S. Mitral clip - looking back and moving forward. Curr Opin Cardiol. 2016;31(2):169–175.

3.  Gammie JS, Wilson P, Bartus K, et al. Transapical beating-heart mitral valve repair with an expanded polytetrafluoroethylene cordal implantation device: initial clinical experience. Circulation. 2016;134:189–197.

4.  Uechi M. Mitral valve repair in dogs. J Vet Cardiol. 2012;14(1):185–192.

5.  Ferrari E. Apical access and closure devices for transapical transcatheter heart valve procedure. Swiss Med Wkly. 2016;146:w14237.