New Delhi: A dog with a complex heart condition successfully underwent a minimally invasive heart surgery at a hospital here with veterinarians claiming it to be the first such procedure to be carried out by private practitioners in the Indian subcontinent. Seven-year-old beagle, Juliet has been suffering from Mitral valve disease for the last two years, Dr Bhanu Dev Sharma, an interventional cardiologist for small animals at Max PetZ Hospital in East of Kailash said on Sunday. The condition is caused by degenerative changes in mitral valve leaflets which result in backflow of blood within the left upper chamber of the heart and subsequent congestive heart failure (fluid build-up in lungs) as the disease progresses.

The surgeons performed a Transcatheter Edge-to-Edge Repair (TEER) procedure using a valve clamp on May 30. "It's called hybrid surgery as it's a combination of a microsurgery and interventional procedure. The best part about this procedure is that it's minimally invasive as it's a beating heart procedure and not like an open heart surgery which needs a heart-lung bypass machine," Sharma explained. As per the pet parents, they have been giving heart medications to Juliet for the last year, Sharma said. They learnt about the procedure from their visit to the US where this surgery was introduced at Colorado State University two years ago, he said. The pet dog was discharged in a stable medical condition just two days after surgery.

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Most common heart condition among dogs
Mitral valve disease is the most common heart condition in dogs in India as well as in the rest of the world and accounts for 80 per cent of all heart diseases in dogs. This disease is among one of the major causes of deaths in dogs, Sharma said. "The only treatment majorly available so far includes medicinal treatment which delays the onset of clinical signs and gives symptomatic relief for some time. It is not curative," he said. Open heart mitral valve repair surgery is not a very viable option owing to the highly invasive nature of the procedure and because it is done at very few centres in the world.

What is Transcatheter Edge-to-Edge Repair?
"TEER is entirely an image-guided procedure and is done under trans oesophageal 4D echocardiography and fluoroscopy guidance in a beating heart. A small incision is made on the chest wall to get access to the apex of the heart after which through a catheter the two leaflets of the diseased mitral valve are clamped together to reduce the leakage across the valve under the guidance of high-tech equipment," Sharma said. According to the veterinary hospital, Sharma's team is the first from Asia and second worldwide among private practitioners to have done the procedure successfully. Sharma and his team of four doctors travelled to Shanghai last year to learn about the procedure. "The procedure is similar in concept to the dogMitra clip procedure in humans which has benefitted and saved many human lives so far. With the launch of this surgery it gives a new ray of hope for dogs suffering from this very common heart disease," Sharma said. 

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