A leaky heart valve (mitral valve endocardiosis) is the most common heart disease in dogs. Especially older animals of small breeds are affected. In human medicine, heart valve replacement has long been the treatment method of choice, but in animals, mitral valve repair surgery is not yet routine. There are only a handful of surgeons worldwide who perform these operations and the procedure is very expensive. More about mitral valve endocardiosis can be found here.
Which dogs are eligible for mitral valve repair surgery?
Dogs with stage B2 or C mitral valve endocardiosis are good candidates for surgery. Surgery is also possible in stage D, but the complication rate is significantly increased. Age also plays a role. The younger, the better. From an age of about 10-12 years, the surgeon may advise against the surgery. The same applies to very small or light animals. Under 3.5 kg body weight it becomes more and more difficult.
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What are the chances of success?
A recently published study looked at success rates in a relatively large number (55) of dogs operated on in Japan. This clinic uses a special technique in valve repair and seems to be very successful with it. Nevertheless, the stage the dogs are at before surgery seems to play a major role. In this study, all 14 stage B2 dogs survived, of 27 stage C dogs, one did not survive the postoperative period, and of 14 stage D dogs, 4 died in the hours or days after surgery. This is a remarkable success rate of about 90%. In any case, the critical period seems to be the first two weeks after surgery.
After only one month, all animals in this study had left ventricular and atrial measurements back in the reference range with no or minimal mitral valve leakage. After only two weeks, almost all medications could be discontinued. A medication to prevent blood clots was given for three months after surgery. In a few cases, medications to reduce pulmonary pressure had to be continued permanently.
Other clinics report similar success rates, usually around 80%-90%. Of course, it always depends on the patient selection. For example, the more dogs are operated on in stage D, the greater the risk of postoperative complications. The clinic in London, for example, gives a success rate in stage D of about 50%.
How expensive is the operation for leaking heart valves?
The costs vary from clinic to clinic and must be inquired individually. In Europe, a sum of about 15.000 euros can be expected. In England the price is about 17.500 pounds. Whereby here still preliminary examinations and follow up exams can come in addition.
Where can you have your animal operated?
Interestingly, most centers are in Europe, the UK or in Japan. Currently (this may change of course) no clinic in the USA seems to perform the surgery, although Americans in particular would often be willing or able to pay for the surgery. The problem for patients outside of these countries may be difficult import requirements and waiting periods. France or Austria might be the easiest to import a dog into for surgery.
- In Austria, Dr. Peter Modler has been operating on dogs with heart disease and especially leaking heart valves for years at the veterinary clinic in Sattledt.
- In England, this procedure has also been offered at the Royal Veterinary College in London for several years.
- In France, Doctors Sabine and Jean-Hugues Bozon operate at the Hopia Clinic near Versailles.
- In Japan, Jasmine Animal Referral Hospital and Shiraishi Animal Hospital perform this operation.
- In Florida, USA, the surgery will be offered at the College of Veterinary Medicine starting in the summer of 2023 (check for updates).
The outcome of surgical mitral valve repair with loop-in-loop technique in dogs with different stage myxomatous mitral valve disease.