Mitral valve regurgitation is a common canine heart disease. Transcatheter Edge-to-Edge Repair (TEER) is a transcatheter, edge-to-edge mitral repair device that uses a hybrid approach. No detailed information has been published on the hemodynamic effect of TEER on cardiac function. The aim of this report is to provide a longitudinal observation of the cardiac functional changes observed after TEER implantation in normal dogs using traditional, two-dimensional speckle tracking, and color M-mode echocardiographic methods. In the current report, TEER was implanted into two healthy dogs under general anesthesia. An echocardiographic examination was performed at baseline and weekly postoperative follow-ups were conducted until the fourth week. Successful TEER implantation was achieved with a short operation time (98 and 63 min) in the two dogs. Functional mitral valve regurgitation, elevated E/e’ ratio, elevated radial strain, and stable intraventricular pressure gradients (IVPG) were observed after the operation in the dogs. Mild non progressive mitral valve stenosis was observed in both dogs. TEER is a minimally invasive method for mitral valve surgery that necessitates more clinical trials. With longitudinal observation of heart function using novel approaches, better outcomes will be expected.

Myocardial infarction (MI) is a serious cardiovascular disease as the leading cause of death globally. Hence, reconstruction of the cardiac tissue comes at the forefront of strategies adopted to restore heart functions following MI. In this investigation, we studied the capacity of rat adipose-derived mesenchymal stem cells (r-AdMSCs) and decellularized porcine pericardium (DPP) to restore heart functions in MI animals. MI was induced in four different groups, three of which were treated either using DPP (MI-DPP group), stem cells (MI-SC group), or both (MI-SC/DPP group). Cardiac functions of these groups and the Sham group were evaluated using echocardiography, the intraventricular pressure gradient (IVPG) on weeks 2 and 4, and intraventricular hemodynamics on week 4. On day 31, the animals were euthanized for histological analysis. Echocardiographic, IVPG and hemodynamic findings indicated that the three treatment strategies shared effectively in the regeneration process. However, the MI-SC/DPP group had a unique synergistic ability to restore heart functions superior to the other treatment protocols. Histology showed that the MI-SC/DPP group presented the lowest (p < 0.05) degeneration score and fibrosis % compared to the other groups. Conclusively, stem cell-seeded DPP is a promising platform for the delivery of stem cells and restoration of heart functions post-MI.

An 8-year-old, 2.2-kg, spayed female Toy poodle presented with stage D heart failure that was unresponsive to medical management. Echocardiography revealed severe mitral regurgitation (left atrial-to-aorta ratio, 2.4; normalized left ventricular internal dimension in diastole, 2.2; and ratio of regurgitant jet area signal to the left atrial area [ARJ/LAA], 65%), anterior leaflet prolapses, and valve billowing. Mitral valve surgery was recommended based on clinical signs and echocardiographic findings. Mitral annuloplasty and expanded polytetrafluoroethylene chordal reconstruction were performed using cardiopulmonary bypass. Intra-operative assessment revealed leaflet thinning, stretching, and multiple perforations, with regurgitant flow arising from these defects. A 1.5 × 1.5-cm fresh autologous pericardium patch was placed and continuously sutured to the atrial aspect of the anterior leaflet to restore structural integrity and coaptation. Postoperative echocardiography on day 6 demonstrated improved cardiac variables, with the vertebral heart size decreasing from 13.3v to 11.8v, left atrial-to-aorta ratio to 2.0, normalized left ventricular internal dimension in diastole to 1.7, and ARJ/LAA to 18.8%. A transient increase in the C-reactive protein level was observed, which resolved within one month. The patient remained asymptomatic with further reduction in cardiac dimensions, minimal residual regurgitation (ARJ/LAA, 6.7% at 12 months), and no patch-related complications. This is the first long-term report describing a successful mitral valve repair using a fresh autologous pericardial patch in a dog. The dog's pericardial patch demonstrated sufficient durability to withstand high left heart pressure while maintaining the flexibility required for valvular function; thus, this technique may be a valuable addition to the current surgical repair methods.

A 3-year-old West Highland White Terrier was presented to our hospital with dyspnoea following aspiration of barium contrast medium during diagnostic imaging for a suspected oesophageal foreign body (day 0). Barium contrast radiography had revealed a foreign body in the lower oesophagus. During anaesthesia, the patient regurgitated and developed respiratory failure and cyanosis. Despite immediate intubation, suction, and ventilatory management, the respiratory parameters remained poor. Respiratory support with extracorporeal membrane oxygenation (ECMO) allowed to control blood gas parameters, and tracheobronchial lavage with temporary complete airway occlusion was performed. ECMO was withdrawn once the respiratory status normalised. The total support time was 3 h. Considering the possibility of hypoxia-induced brain damage, the patient was extubated on day 1. The dog was alert, changed positions, and drank water independently 5 h after extubation. However, neurological symptoms were observed 1 h later. Cranial magnetic resonance imaging was performed on day 6 because of persistent neurological symptoms. Although no ECMO-related complications, such as cerebral infarction, haemorrhage, or herniation, were observed, the white matter showed hyposignal, indicating hypoxic encephalopathy. The patient died on day 8, without improvement in neurological symptoms. ECMO is an effective treatment option for dogs with respiratory failure, and its prompt introduction could improve survival in applicable cases.

A 3-year-old West Highland White Terrier presented to our hospital with dyspnea following aspiration of barium contrast medium during diagnostic imaging for a suspected esophageal foreign body (day 0). Barium contrast radiography had revealed a foreign body in the lower esophagus. During anesthesia, the patient regurgitated and developed respiratory failure and cyanosis. Despite immediate intubation, suction, and ventilatory management, respiratory parameters remained poor. Respiratory support with extracorporeal membrane oxygenation (ECMO) enabled control of blood gas parameters, and tracheobronchial lavage with temporary complete airway occlusion was performed. ECMO was withdrawn once the respiratory status normalized (total support time: 3 h). Considering the possibility of hypoxia-induced brain damage, the patient was extubated on day 1. The dog was alert, changed positions, and drank water independently 5 h after extubation. However, neurological symptoms were observed 1 h later. Cranial magnetic resonance imaging was performed on day 6 owing to persistent neurological symptoms. Although no ECMO-related complications, such as cerebral infarction, hemorrhage, or herniation, were observed, the white matter exhibited hyposignal, indicating hypoxic encephalopathy. The patient died on day 8, without improvement in neurological symptoms. ECMO is an effective treatment option for dogs with respiratory failure, and its prompt introduction may improve survival.

In humans, surgical repair is commonly performed for infective endocarditis (IE) associated with mitral valve destruction. However, extensive valve destruction may make repair impossible and require prosthetic valve replacement. In small-breed dogs, appropriately sized prosthetic valves are lacking, and complete surgical mitral valve reconstruction in dogs has not been reported. We encountered a Chihuahua that developed IE after mitral valve repair. During reoperation for progressive mitral regurgitation recurrence, the mitral leaflets were extensively destroyed and torn, and re-repair using native tissue was impossible; the entire valve was therefore reconstructed with fresh autologous pericardium. A graft was harvested and fashioned into a cylindrical valve based on a design previously described in a human study. Intraoperative saline testing and immediate postoperative echocardiography confirmed adequate opening and closure of the reconstructed pericardial valve, with only mild mitral regurgitation and no stenosis. The dog died on the second day after reoperative day of an uncontrolled infection caused by extended-spectrum beta-lactamase-producing Escherichia coli. This case demonstrates that an autologous pericardial valve can provide short-term mechanical function as a mitral valve in a small-breed dog and indicates that infection control is the principal determinant of outcome.