Mitral valve endocardiosis (also called myxomatous mitral valve disease) is the most common heart disease in dogs, particularly affecting older dogs of small breeds. The condition causes a leaky mitral heart valve, which can eventually lead to congestive heart failure.

In human medicine, heart valve replacement or repair has been standard practice for decades. In veterinary medicine, however, mitral valve repair surgery in dogs is still not routine. Only a small number of highly specialized surgeons worldwide perform this operation, and the procedure is technically demanding and expensive.

This article explains which dogs are eligible, how successful the surgery is, how much it costs, and where it is currently available, including a comprehensive list of veterinary centers performing this surgery.

What Is Mitral Valve Endocardiosis in Dogs?

Mitral valve endocardiosis is a degenerative disease of the mitral valve, leading to progressive valve leakage (mitral regurgitation). Over time, this causes enlargement of the left atrium and ventricle and may progress to heart failure.

Medical therapy can slow disease progression and manage symptoms, but surgery is currently the only curative treatment.

Which Dogs Are Eligible for Mitral Valve Repair Surgery?

Disease Stage

Dogs with stage B2 or stage C mitral valve disease are considered good candidates for mitral valve repair surgery.

  • Stage B2: Structural heart changes are present, but no clinical signs yet

  • Stage C: Dogs show signs of heart failure that respond to medication

  • Stage D: End-stage disease; surgery is possible but associated with a significantly higher risk of complications

Age and Body Weight

  • Younger dogs have better outcomes

  • From approximately 10–12 years of age, surgeons may advise against surgery

  • Very small dogs are more challenging surgical candidates

    • Below 3.5 kg (7.7 lbs) body weight, the procedure becomes increasingly difficult

Proper patient selection is crucial for success.

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What Are the Success Rates of Mitral Valve Repair in Dogs?

A recently published study evaluated 55 dogs that underwent mitral valve repair surgery in Japan using a specialized surgical technique.

Survival Rates by Disease Stage

  • Stage B2: 14/14 dogs survived (100%)

  • Stage C: 26/27 dogs survived

  • Stage D: 10/14 dogs survived; 4 died within hours or days after surgery

Overall, this represents a success rate of approximately 90%, with the first two weeks after surgery being the most critical period.

Postoperative Outcomes

  • After one month, all surviving dogs had:

    • Left atrial and ventricular sizes back within reference ranges

    • No or only minimal mitral valve leakage

  • After two weeks, almost all heart medications could be discontinued

  • Anticoagulant medication was given for three months postoperatively

  • In some dogs, pulmonary hypertension medication had to be continued long-term

Other clinics report similar success rates (80–90%), depending heavily on case selection.
For example, some centers report a stage D success rate closer to 50%.

How Much Does Mitral Valve Repair Surgery Cost?

The cost of mitral valve repair surgery varies by clinic and country.

  • Europe: approximately €12,000 – €15,000

  • United Kingdom: approximately £17,500

Additional costs may apply for:

  • Preoperative diagnostics

  • Travel and import requirements

  • Postoperative follow-up examinations

Owners should always request a detailed cost estimate directly from the clinic.

Veterinary Clinics Performing Mitral Valve Repair Surgery

Only a limited number of specialized centers worldwide currently perform this surgery. Here’s an up-to-date list:

Europe & United Kingdom

Country Clinic / Hospital Notes
Austria Veterinary Clinic Sattledt Dr. Peter Modler, experienced in mitral valve repair
United Kingdom Royal Veterinary College, London (Queen Mother Hospital for Animals) Specialist team, published outcomes
France Hopia Clinic, Versailles Surgeons: Dr. Sabine Bozon & Dr. Jean-Hugues Bozon

Japan

Clinic Notes
JASMINE Animal Referral Hospital World-renowned for mitral valve repair in dogs
Shiraishi Animal Hospital High surgical volume, excellent outcomes

United States

State Clinic / Hospital Notes
Florida University of Florida College of Veterinary Medicine Open-heart surgery program starting summer 2023; check for updates
Florida Sawgrass Veterinary Cardiology Offers minimally invasive TEER & V-Clamp procedures

Asia-Pacific & Middle East

Country Clinic / Hospital Notes
Thailand Chulalongkorn University Veterinary Hospital (Bangkok) Offers open-heart & minimally invasive valve repair
South Korea NEL Animal Cardiovascular Center Advanced cardiac surgery including mitral repair
UAE British Veterinary Centre, Abu Dhabi First open-heart mitral valve repair in the MENA region
Australia Veterinary Cardiologists Australia TEER and V-Clamp valve repair with visiting surgeons

Notes on Minimally Invasive Valve Repair (TEER / V-Clamp)

  • Transcatheter Edge-to-Edge Repair (TEER) is a newer technique that reduces valve leakage without full open-heart bypass.

  • TEER is available in select U.S., Australia, and Thailand veterinary hospitals.

  • Clinical trials and collaborations are expanding its availability.

Practical Considerations for Pet Owners

  • Patient selection matters: stage of disease, age, and weight influence outcomes.

  • Travel and import regulations: International travel can be complicated for surgery.

  • Cost planning: Surgery is expensive, and follow-up care is essential.

France and Austria are often among the easiest countries in Europe for importing dogs for surgery in case your country does not have a clinic that provides the service yet.

Final Thoughts

Mitral valve repair surgery offers a potential cure for dogs with mitral valve endocardiosis. The procedure requires:

  • Careful patient selection

  • Highly specialized surgical expertise

  • Significant financial investment

For the right dog, at the right stage, the results can be life-changing.

 

References:

The outcome of surgical mitral valve repair with loop-in-loop technique in dogs with different stage myxomatous mitral valve disease.

mitral-valve-information-sheet.pdf