Transcatheter Edge-to-Edge Mitral Valve Repair (TEER)

Transcatheter Edge-to-Edge Repair (TEER) is a minimally invasive mitral valve repair for dogs with congestive heart failure due to mitral valve disease. It reduces backflow and improves heart function without requiring open-heart surgery.

What Is Myxomatous Mitral Valve Disease (MMVD)?

Myxomatous Mitral Valve Disease (MMVD) is a degenerative heart condition, particularly affecting older, small breeds, such as the Cavalier King Charles Spaniel, Dachshund and Miniature Poodle. The disease weakens the mitral valve, allowing blood to leak backward from the heart into the lungs—a problem called mitral valve regurgitation. This backflow forces the heart to work harder to circulate oxygenated blood, gradually enlarging the heart and straining its capacity.

Diagnosis is usually confirmed through echocardiography, which provides detailed images of the heart’s structure and performance. While MMVD cannot be cured, early detection and proper management can slow its progression and help maintain a better quality of life.

In advanced cases, minimally invasive options such as the Transcatheter Edge-to-Edge Repair (TEER) procedure may be considered, providing a way to improve heart function without open-heart surgery.

What Is TEER?

TEER is a new, innovative technique that treats mitral heart disease in dogs. If left untreated, it can lead to Congestive Heart Failure (CHF).

It involves the use of an implant (V-Clamp) through a catheter into the beating heart without any cardiopulmonary bypass. Overall, this reduces blood backflow and helps the heart pump more efficiently. By supporting the mitral valve’s leaflets, TEER helps the valve close more effectively, reducing blood backflow and allowing the heart to pump more efficiently.

Benefits of TEER Procedure

The TEER procedure offers new hope for dogs suffering from stage B2 or early-stage C mitral valve disease. It also has a high success rate once the procedure is completed. Other benefits of the TEER procedure may include:

• Minimally Invasive

  TEER requires only a small surgical opening between the ribs. Through this access point, the catheter and device are placed directly into the heart to correct the faulty valve. By avoiding a full chest opening, surgical trauma is minimised, reducing the need for post-op medications and lowering the risks linked to major surgery.

• Shorter Recovery

  Most dogs recover much faster after TEER compared to open-heart surgery, with many able to go home within 2–3 days. Since the procedure involves only a small incision and minimal tissue disruption, pets typically regain mobility and comfort sooner, making recovery smoother and less stressful for both dogs and their owners.

• Long-Term Heart Health

  TEER reduces the stress placed on the heart, helping to slow the progression of heart enlargement and heart failure. With consistent medical management and follow-up care, dogs can maintain more stable heart function and enjoy a reduced risk of sudden decline.

• Improved Lifespan

  When cardiac stress is controlled and symptoms are well-managed, dogs with MMVD can live longer, more comfortable lives. Beyond extending lifespan, TEER supports better day-to-day well-being, allowing your dog to stay active, alert, and connected with the family they love.

Signs Your Dog May Have MMVD

MMVD often develops gradually, and many dogs show no symptoms in the early stages. It’s commonly detected when a vet hears an unusual heart sound, called a heart murmur, during a routine examination. This murmur occurs when blood leaks backward through the weakened mitral valve.

As the disease advances, more obvious signs might begin to surface. Contact our vet clinic if your dog shows:

• Coughing or shortness of breath
• Fainting after an activity
• Fatigue or slowing down on walks
• Decreased appetite or gradual weight loss
• Faster or heavier breathing, panting even at rest

Candidate Evaluation: Is My Dog Suitable for TEER?

Not every dog with mitral valve disease is suited for the TEER procedure. Candidacy depends on several factors, including the stage of heart disease, the dog’s overall health, and the structure of the mitral valve.

In general, the best candidates are dogs who:

• Have been diagnosed with MMVD stage B2 or C, showing significant valve leakage along with heart enlargement or early signs of heart failure.
• Are under 12 years old (though there is no strict age limit).
• Weigh between 4 and 15 kg.

Dogs in late-stage C or stage D, or those with atrial fibrillation, are typically not suitable for TEER, as their heart condition may be too advanced for the procedure to offer meaningful benefit. A consultation with your veterinary doctor is the best way to assess your dog’s condition and determine whether TEER is an appropriate treatment option.

What to Expect

Pre-Procedure Evaluation

Before the procedure, your dog will undergo a thorough assessment that includes a physical examination, chest imaging, and echocardiography. This step determines if TEER is suitable and how best to approach the repair safely and effectively.

During the Procedure

On the day of the procedure, your dog is placed under general anaesthesia with continuous monitoring. The cardiology team uses live ultrasound inside the oesophagus and fluoroscopy to guide a catheter across the valve opening. A small device called a V Clamp is delivered through the catheter and positioned to grasp the valve leaflets. The procedure typically takes 60–80 minutes.

Once the repair is complete, the catheter is withdrawn, and the small incision is closed. Your dog will then be transferred to a critical care unit for close monitoring during recovery.

After the Procedure

Most dogs stay in the hospital for one to three days following the procedure. On average, mitral regurgitation is reduced by 50–90%, though individual results vary depending on valve structure and disease progression. Your veterinary team will continue to monitor your dog’s recovery and adjust medication as needed to support long-term heart health.

Potential Risks or Complications of TEER in Dogs

Although the TEER procedure has shown encouraging success in managing mitral valve disease, it still carries certain risks, as with any medical intervention. Possible complications include:

• Clamp Detachment - One of the most significant complications is the detachment of the clamp used to repair the valve. If this occurs, particularly within the first 72 hours after surgery, it can be life-threatening.
• Bleeding and Infection - Like any surgical procedure, this one carries risks such as bleeding during or after the operation, infection at the incision site, or irregular heart rhythms.
• Pneumothorax - A build-up of air in the chest cavity might occur following surgery, which requires prompt medical attention.
• Device-Related Issues - In some cases, the mitral valve may not close completely after the procedure, although this is typically identified during the immediate post-operative imaging.

Why Choose Advanced VetCare for TEER Procedure

When it comes to treating mitral valve disease, having the right expertise matters just as much as the technology used. At Advanced VetCare, the Transcatheter Edge-to-Edge Repair (TEER) procedure is led by Dr. Nicholas Woo, a highly experienced veterinarian specialising in complex cardiac procedures.

Dr Woo brings together years of clinical practice with specialised training in both Australia and Singapore. Known for his precision and compassionate care, he has successfully performed numerous TEER procedures—helping many dogs regain their vitality and enjoy more time with their families.

FAQs About TEER

How does TEER’s V-Clamp work?

The V-Clamp is the veterinary counterpart to the human MitraClip.

It is approximately 8 mm in length and is implanted to clamp together the two mitral valve leaflets in patients, reducing backflow of blood through the valve.

The veterinary V-Clamp has been available for the last 3 years, while the human MitraClip has been successfully implanted in over 150,000 humans worldwide and demonstrated superior results over medical treatment.

How long will my dog live after TEER?

For dogs with advanced myxomatous mitral valve disease and fluid in the lungs (ACVIM Stage C), medical management alone often limits life expectancy to about 6 to 12 months.

With TEER, survival improves considerably, with around 80% of patients alive at one year and nearly 78% still doing well at two years after surgery.

Will my dog still need medication after TEER?

Yes. Most dogs will continue taking heart medication after the procedure to support ongoing heart function.

Over time, your veterinary cardiologist will reassess your dog’s condition and may reduce or adjust the dosages as recovery progresses.

What happens if TEER isn’t successful?

If the procedure doesn’t achieve the desired result, your veterinarian will focus on optimising medical therapy and exploring other treatment options.

You’ll receive clear guidance on the safest next steps to keep your dog as comfortable and stable as possible.

How much does the TEER procedure cost for dogs?

Costs can vary depending on the clinic, the level of aftercare required, and whether intensive monitoring is needed.

Your veterinary cardiologist will provide a personalised cost estimate after evaluating your dog’s condition.

It’s also important to plan for long-term follow-up care and medications after surgery.

Are there alternative treatments for dogs with the same heart condition?

Yes. Many dogs are managed with medication, which helps control symptoms even though it can’t fully stop the disease from progressing.

In some specialist centres, open-heart valve replacement surgery may also be an option, though it carries higher risks and isn’t commonly performed.

Your vet will help you decide on the best approach for your dog’s health, comfort, and daily lifestyle.

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