Specialist care for dogs with mitral regurgitation
The Veterinary Mitral Valve Centre (Tiermedizinisches Mitralklappenzentrum) at RA Kardiologie/AniCura Alzenau provides specialised diagnostic, clinical, medical and interventional care for dogs affected by mitral valve disease.
Our particular focus is degenerative or myxomatous mitral valve disease (DMVD/MMVD), also known as mitral valve endocardiosis. It is one of the most common acquired heart diseases in dogs and, when advanced, can result in severe mitral regurgitation, progressive enlargement of the heart and eventually congestive heart failure with pulmonary oedema.
Our aim is to develop an individual treatment strategy for each patient – from cardiological monitoring and optimised medical management to advanced interventional procedures.
What is a Veterinary Mitral Valve Centre?
A Mitral Valve Centre brings together the different diagnostic and therapeutic options available for patients with mitral valve disease.
The diagnosis of “mitral regurgitation” alone is not sufficient to determine the best treatment. The severity of regurgitation, cardiac size and function, individual mitral valve anatomy, stage of disease, previous episodes of heart failure and concurrent diseases all need to be considered.
Our services include:
- Comprehensive cardiological assessment
- Echocardiography
- Detailed mitral valve imaging
- Individualised medical therapy
- Assessment for interventional treatment
- V-Clamp TEER
- Left atrial decompression by atrial septostomy
- Cardiological follow-up
Procedures at AniCura Alzenau – an experienced multidisciplinary team
The interventional procedures of our Mitral Valve Centre are performed at AniCura Alzenau.
These advanced procedures are supported by a highly experienced multidisciplinary team providing comprehensive care before, during and after the intervention.
The team includes specialists and experienced professionals in:
- Interventional cardiology
- Anaesthesia
- Thoracic surgery
- Internal medicine
- Intensive and critical care
- Specialised operating theatre nursing
- Specialised intensive care nursing
This multidisciplinary approach is particularly important when treating complex cardiac patients. Experienced anaesthetists and critical care specialists work alongside the interventional cardiologist to provide optimal perioperative management, including for dogs with advanced heart disease.
Thoracic surgical expertise is also available. In the rare event that an interventional procedure needs to be converted to a surgical procedure, the appropriate surgical expertise is therefore immediately available.
After the intervention, patients are closely monitored by our medical team and experienced intensive care nurses. Combining expertise in cardiology, anaesthesia, surgery and critical care allows us to provide comprehensive treatment even for particularly complex patients.
TEER with V-Clamp – minimally invasive mitral valve repair
In suitable patients, Transcatheter Edge-to-Edge Repair (TEER) can be performed using the V-Clamp specifically developed for dogs.
The device brings selected portions of the leaking mitral valve leaflets together, improving leaflet coaptation and reducing the amount of blood flowing backwards from the left ventricle into the left atrium.
Unlike conventional open-heart surgery, the heart continues to beat during the procedure and cardiopulmonary bypass is not required.
Suitability for TEER depends strongly on individual mitral valve anatomy, cardiac dimensions and other cardiological factors.
Atrial septostomy – left atrial decompression in advanced disease
For patients with advanced mitral valve disease, our centre also offers atrial septostomy, or left atrial decompression.
During this interventional procedure, a controlled communication is created between the left and right atrium. Its purpose is to decompress the high-pressure left atrium and thereby reduce pressure transmitted towards the pulmonary circulation.
Unlike TEER, atrial septostomy does not repair the diseased mitral valve. It is a palliative interventional treatment that can provide an important option for selected dogs with advanced heart failure.
Additional options for complex patients
A particular advantage of our Mitral Valve Centre is that we perform both V-Clamp TEER and atrial septostomy.
This enables us to assess and treat more complex cases using different interventional strategies.
If a dog is initially unsuitable for TEER because of cardiac size, mitral valve anatomy or advanced disease, atrial septostomy may represent an alternative treatment in appropriately selected cases.
In some patients, left atrial decompression may subsequently reduce cardiac volume overload and allow the heart to become smaller. This can alter the anatomical conditions relevant to V-Clamp implantation. A patient who was initially unsuitable for TEER may therefore be reassessed later to determine whether TEER has become possible.
Later TEER cannot be guaranteed and always requires a new detailed cardiological and echocardiographic assessment.
Open-heart mitral valve surgery
Another treatment option is surgical mitral valve repair performed during open-heart surgery using cardiopulmonary bypass.
This procedure is not currently available at our centre.
Open mitral valve surgery is performed at a small number of highly specialised international centres, including centres in the Paris region and London. If open surgical repair may be appropriate, we can advise owners and assist with cardiological preparation and referral documentation.
Individual treatment rather than a standard solution
Mitral valve disease does not progress in exactly the same way in every dog, and no single treatment is appropriate for every patient.
Our approach combines diagnostics, medical management and interventional cardiology, with repeated reassessment as the disease evolves.
Our priorities are the patient's quality of life, control of congestive heart failure and – whenever possible – reduction of the underlying mitral regurgitation.
Cardiology for Veterinarians
