THE TUCKER VALVE™

The Tucker ValveValve

The Tucker Valve is one of the veterinary medical devices currently in our development pipeline.  It is a transcatheter valve device which can be used to treat dogs with degenerative mitral/tricuspid valve disease.

Severe Degenerative Valve Disease

Degenerative valve disease is a very common problem in dogs.  Small breed dogs, including Cavalier King Charles Spaniels, poodles, terriers, among others, are most commonly affected.  Currently there is no medical cure.  This disease causes the mitral or tricuspid valve leaflets to become abnormally thickened.  This hinders the valves ability to form a tight seal between the atrium and ventricle.  As a result, blood in the ventricle now flows back into the atrium through the leaky valve (known as regurgitation) instead of moving forward from the ventricle into the aorta or pulmonary artery.  The condition is progressive and over time the valve will continue to degrade until the heart can no longer compensate.  The result is congestive heart failure, a condition in which edema fluid fills the lungs.  Medical therapy can help control the clinical signs, but eventually most dogs die of the disease.

x-ray-heart-failure

The first image on the left shows a normal K9 heart on x-ray.  The second image shows congestive heart failure on x-ray.

 

Medical therapy for severe degenerative valve disease is palliative at best in both dogs and in man.  The definitive treatment for severe degenerative valve disease in man is surgical valve replacement or repair.  Surgical valve repair options in dogs have intrinsic limitations and is not available at most veterinary specialty centers or universities.  Transcatheter valve replacement is a potential new therapeutic option that avoids the limitations and complications of open heart valve replacement or repair.  It would also be more accessible, less expensive and much less invasive compared to surgical repair or replacement.

Ultravet Medical Devices performed a pilot study in 2013.  The purpose of this study was to demonstrate that transcatheter valve replacement is a viable therapeutic treatment in dogs with degenerative valve disease.  Three Labrador retrievers with severe tricuspid valve dysplasia were selected for transcatheter valvular replacement.  All three dogs had severe right-sided heart enlargement, large tricuspid regurgitations and heart failure.  All of these dogs were on multiple cardiac medications that could not stop the worsening heart failure.

An experimental, prototype transcatheter valve was designed and manufactured by Ultravet Medical Devices.  The device was named the Tucker Valve™ after Dr. Kramer’s dog Tucker, who was one of the dogs in the study.  It was passed down the jugular vein under fluoroscopic and ultrasonic guidance, fixed into the apex at the right ventricle and deployed between the tricuspid leaflets.  Intra-operative  and post-op echocardiography showed marked reduction of the tricuspid regurgitant jet in all three patients.

Pictured below left is a color flow Doppler image from one of the patients in the pilot study.  The color mosaic indicates severe tricuspid regurgitation.

pre                                              post

Pictured above right is a color flow Doppler image from the same patient after the valve device was placed in position demonstrating a marked reduction in the amount of regurgitation.

The Tucker tucker-valveValve™ was successfully deployed into the right ventricle via the transcatheter jugular approach in all three dogs.  The device resulted in significant reduction of the naturally occurring tricuspid regurgitation in all three dogs.  This study showed that transcatheter valve replacement is possible in dogs and can dramatically reduce the amount of regurgitation.

Development on this device continues.  Please see below for a video animation of how the Tucker Valve™  works.