Case Background
On December 8th, 2024, Dr. Anthony Leong and his team successfully completed Malaysia’s first-ever V-Clamp surgery on a MMVD stage B2 patient named Oscar. This landmark achievement means that the V-Clamp procedure is now accessible to patients in Malaysia suffering from Mitral Valve Disease (MMVD), offering them a cutting-edge treatment option.
Oscar is a 6-year-old Cavalier King Charles Spaniel who had been diagnosed with advanced-stage B2 myxomatous mitral valve disease (MMVD) in June 2024. After diagnosis, he had been given pimobendan, benazepril, and spironolactone to manage the disease. Understanding the high risk of the disease progressing from stage B2 to heart failure, Oscar’s owners decided to move forward with the V-clamp surgery as a treatment option.
The surgery was a success. Preoperatively, Oscar’s AP diameter measured approximately 21mm, with prolapse of the anterior leaflet in zones 2 and 3, and posterior leaflet tethering extending into zone 2 near zone 3. The anterior leaflet measured around 11mm, while the posterior leaflet was 8.5mm in size. A gap was observed between the anterior and posterior leaflets, with regurgitation affecting zones 1 through 3. A type IV V-Clamp was applied, with the clamp positioned between zones 2 and 1. The procedure involved a single clamping, which reduced regurgitation by 80%, with minimal remaining leakage in zone 3. The clamping volume was approximately 8mm on the anterior leaflet and 6mm on the posterior leaflet. The average transvalvular pressure gradient was around 0.8.
Clinical Presentation
Oscar was discharged after two days of critical care monitoring. Post-surgery, the mitral regurgitation showed significant improvement. A chest radiograph taken four days after the procedure revealed a reduction in the size of the left atrium. Ongoing follow-up visits will be necessary to monitor Oscar's condition and adjust medications as needed.
Doctor’s Profile
Procedure & Outcome
Dr Anthony Leong holds a DVM from Universiti Putra Malaysia and a PhD from The United Graduate School of Veterinary Science at Yamaguchi University, Japan.
Doctor Leong is a self-employed companion veterinarian and a visiting cardiology consultant who operates the Shinzo Cardiology Clinic under Leong VetCardio Services at Kota Damansara Veterinary Centre. He is a former industrial fellow at Universiti Malaysia Kelantan and this experience further underscores his dedication to advancing the field of veterinary cardiology in Malaysia. He is also a speaker for several cardiology webinar sessions for veterinarians and veterinary students in Malaysia.
Through the collaborative efforts of our global partners, we aim to make the V-Clamp procedure a transformative treatment for MMVD patients, helping them achieve a longer, healthier, and higher-quality life.
