Mitral transcatheter edge-to-edge repair: guidance in dogs from the human experience

Mitral regurgitation is the most prevalent valvular heart disease in dogs and humans, leading to symptoms of heart failure, reduction in the quality of life, recurrent hospitalizations, and increased mortality. Mitral transcatheter edge-to-edge repair (M-TEER) is an established intervention for severe mitral regurgitation in human patients and has recently emerged as a promising intervention in dogs. The prospect of a minimally invasive intervention for dogs is a breakthrough development and simultaneously raises important questions of procedural timing, documenting benefit vs. risk, and outcomes compared to surgical repair or medical therapy alone. The evolution of M-TEER in humans has been documented through early feasibility studies, randomized clinical trials comparing M-TEER to medical therapy or surgical repair, and national and international registries. This review focuses on M-TEER technologies, patient selection, procedural performance, and outcomes in humans and dogs. A major goal of this review is to draw upon the extensive human experience as potentially useful in guiding the rollout in dogs and to review the many lessons learned in the human experience that may be relevant to M-TEER in dogs.