Translational Strategies for Developing and Evaluating Transcatheter Devices in Swine Heart Failure Models

Developing a therapeutic transcatheter device for cardiovascular diseases requires precise preclinical large animal models and robust evaluation methods. Three key aspects are essential for evaluating the safety and efficacy of a device: (1) types of swine heart failure models, (2) appropriate echocardiographic methods, and (3) the specific implantation approaches in swine. Common heart failure models include rapid pacing heart failure models, volume overload models, and ischemic models. Among the ischemic models, several approaches are performed to replicate the pathological conditions, such as coronary artery ligation, ameroid constrictor implantation, balloon occlusion, and coronary embolization. The optimal choice of echocardiographic method varies based on the procedure and includes transthoracic, transesophageal, intracardiac, and epicardial techniques. Echocardiographic imaging serves as an invaluable tool in both preclinical and clinical settings, providing structural and functional assessments, procedural guidance during device placement, and comprehensive evaluations of cardiac function and structural changes before and after implantation. Implantation approaches, such as trans-atrial, trans-apical, trans-septal, and trans-right pulmonary methods, each offer unique advantages and challenges. A thorough understanding of these approaches, including the orientation of the catheter tip relative to critical anatomical structures like the mitral annulus or coronary vasculature, is essential for ensuring procedural success. This review explores these aspects to contribute to the development and refinement of catheter-based cardiovascular interventions, ensuring reliability in preclinical data and successful clinical translation.