Concierge cardiac surgery · UK
Mitral valve surgery, repair before replacement.
Repair or replacement of the mitral valve - for regurgitation, stenosis or endocarditis - with a repair-first consultant cardiac surgeon, mini-mitral access where it fits, and a candid steer on whether MitraClip belongs on your list.
Why patients choose us
- 01
Repair-first surgeons, honestly
A named consultant cardiac surgeon whose repair rate for degenerative disease is over 85 percent - not a general operator who defaults to replacement.
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Mini-mitral where it fits
A 5–6 cm right-sided incision under the breast, femoral bypass, faster recovery - offered when your anatomy and pathology allow it, not sold blindly.
- 03
Independent, and free
We are paid by no hospital or surgeon, so the recommendation is impartial and the service costs you nothing.
Indicative pricing
What private mitral valve surgery costs in the UK.
Indicative ranges across our partner cardiac units. NHS-funded surgery is free at the point of care. Send the details and we quote firm figures across two or three options.
In short
A mitral repair in our network: £35,000–£55,000, home in 5–7 days.
| Procedure | Indicative range | Operating time | Hospital stay |
|---|---|---|---|
| Mitral valve repair (sternotomy) | £35,000–£55,000 | 3–4 hours | 5–7 day stay |
| Mitral valve replacement (sternotomy) | £40,000–£60,000 | 3–5 hours | 5–7 day stay |
| Mini-mitral (right thoracotomy) | £40,000–£60,000 | 4–5 hours | 4–6 day stay |
| Robotic-assisted mitral (Da Vinci) | £50,000–£70,000 | 4–6 hours | 4–6 day stay |
| Concomitant tricuspid repair (add-on) | £4,000–£8,000 | +30–45 min | Same admission |
| Concomitant Maze / LAA closure (add-on) | £5,000–£10,000 | +45–60 min | Same admission |
| Consultant surgical opinion only | £300–£500 | 45 min | Same visit |
Prices vary by hospital, by which surgeon leads the case, by whether repair or replacement is required, and by any concomitant procedures (tricuspid, Maze, LAA closure, CABG). We come back with a firm quote within one working day.
The problem
The right surgeon, the right approach, the right prosthesis.
Mitral surgery is where surgeon volume and repair rate visibly change your long-term outcome. Whether repair is offered, whether mini-mitral is even considered, and which prosthesis is chosen - none of it is standard. We pick the surgeon before we pick the plan.
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Not sure if it is even reparable?
A senior surgeon reads your TOE and tells you honestly - before you commit to a valve you might not need.
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Sternotomy or mini-mitral?
The right answer depends on your anatomy, pathology and habitus - not the surgeon’s comfort zone.
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Mechanical or tissue valve?
Age, lifestyle, warfarin tolerance, pregnancy plans - a proper conversation, not a form.
The journey
From enquiry to cardiac rehab - what happens, in order.
One team from first message through workup, MDT, theatre, ITU and rehab - including the follow-up echo.
Phase 1 · Before your operation
Workup and MDT, off-stage for you
Phase 2 · Admission and theatre
A week in hospital
Phase 3 · Rehab
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Your echo report, symptoms, mechanism of MR or MS if you know it, and any other cardiac history.
- 02
Before
We come back with a recommendation
Within one working day: the right surgeon, whether repair is realistic, whether mini-mitral fits, and an indicative price range.
- 03
Before
Workup and MDT
Transoesophageal echo, coronary angiogram over 40, dental clearance, PFTs, carotid Doppler, prehab. Discussed at cardiac MDT.
- 04
Admission
Admission and anaesthetic
Admission the day before or the morning of. General anaesthetic, arterial and central lines, TOE probe placed after induction.
- 05
Admission
The operation
Sternotomy or right mini-thoracotomy, cardiopulmonary bypass, repair (ring, chords, resection) or replacement (mechanical or tissue). Three to five hours.
- 06
Admission
Wake up on ITU
Extubated the same evening or overnight. 24–48 hours on ITU, then step-down to a cardiac ward. Drains and pacing wires come out over a few days.
- 07
After
Ward, discharge, cardiac rehab
Home at day 5–7. Cardiac rehab for 6–12 weeks. Anticoagulation reviewed. Follow-up echo and consultant review at 6 weeks.
Typical enquiry to surgery: 3–4 weeks for elective cases. Full recovery: 3–4 months.
When it helps
When mitral valve surgery is the right step.
The situations we see most, plus the one red flag that means a same-day emergency rather than an outpatient booking.
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Primary (degenerative) MR
Mitral valve prolapse - Barlow’s, fibroelastic deficiency, flail leaflet. The commonest indication for repair.
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Secondary (functional) MR
MR from a dilated, poorly contracting left ventricle. Surgery vs MitraClip is an MDT decision, not a default.
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Rheumatic mitral stenosis
Symptomatic MS with valve area under 1.5 cm². Balloon valvuloplasty first for pliable valves; surgery for calcified or regurgitant ones.
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Endocarditis with severe MR
Acute or antibiotic-refractory infective endocarditis with severe regurgitation, abscess, or a large vegetation at embolic risk.
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Asymptomatic MR with LV changes
Severe MR with LVEF under 60 percent, LVESD 40 mm or more, pulmonary hypertension 50 mmHg+, or new AF - surgery is indicated even without symptoms.
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Congenital mitral disease
Parachute mitral valve, cleft leaflet, hypoplastic annulus - usually presenting in younger adults, often reparable.
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Cardiac tumour on the valve
Left atrial myxoma or papillary fibroelastoma involving the mitral apparatus - removed at the same operation.
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Red flag: acute pulmonary oedema
A flail leaflet, ruptured chordae or acute endocarditis can cause sudden severe MR and pulmonary oedema. This is an emergency - A&E, not a clinic booking.
Procedure options
Repair techniques, prosthesis choice, mini-mitral access.
What each option on the table actually involves - and which pathology it best fits.
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Ring annuloplasty
A semi-rigid ring (Physio, Carpentier, Cosgrove) supports a dilated mitral annulus. Almost every repair uses one.
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Quadrangular resection (P2 flail)
The classic Carpentier technique: the prolapsing segment of the posterior leaflet is removed and the leaflet re-approximated.
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Artificial (PTFE) chords
Neochordae of ePTFE (Gore-Tex) replace ruptured or elongated chords, particularly for anterior leaflet prolapse.
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Chordal transfer
Healthy chords from the posterior leaflet are transferred to support a prolapsing anterior leaflet - a reliable non-resectional option.
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Commissurotomy (rheumatic MS)
Fused commissures are divided under direct vision. Reserved for calcified or regurgitant valves not suitable for balloon valvuloplasty.
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Mechanical replacement
St Jude, ATS or On-X bileaflet valves. Lasts 30+ years but needs lifelong warfarin with an INR of 2.5–3.5.
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Bioprosthetic (tissue) replacement
Perimount, Trifecta, Mitroflow, Epic - no long-term anticoagulation. Durability 15–20 years, so preferred for older patients, women who may want pregnancy, and warfarin-intolerant patients.
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Mini-mitral or robotic approach
A 5–6 cm right-lateral thoracotomy or Da Vinci robotic approach with femoral bypass. Faster recovery, better cosmesis, comparable durability in the right hands.
Our vetted UK network
A small panel of cardiac surgeons, we picked them.
Consultant cardiac surgeons across the major UK centres. Not listed publicly - introductions are made privately, once we have read your echo and understood your case.
Selection criteria
How we choose every surgeon in our network.
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Consultant cardiac surgeons on the SCTS national register
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Mitral-repair rate over 85 percent for degenerative disease
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Mini-mitral experience where anatomy allows - not sternotomy by default
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Full cardiac MDT - surgeon, imaging cardiologist, anaesthetist, intensivist
Safety and recovery
What to expect afterwards - honestly.
Mitral valve surgery is one of the most refined operations in cardiac surgery, but it is still open-heart surgery on cardiopulmonary bypass. Elective mortality is 1–3 percent in fit patients, higher in endocarditis and redo cases.
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Repair beats replacement long-term
For degenerative MR, repair gives better 10- and 20-year survival than replacement and avoids lifelong warfarin. That is why a repair-first surgeon matters.
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Mechanical valves mean lifelong warfarin
INR 2.5–3.5 for the rest of your life, with roughly a 2–3 percent per year risk of bleeding or thromboembolism. Not a small commitment.
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Tissue valves wear out
Bioprosthetic mitral valves last 15–20 years. Reoperation for structural failure at 15 years runs to 20–30 percent - it is a trade-off against warfarin.
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Atrial fibrillation is common after
Post-op AF affects 30–40 percent of patients. It usually settles, but a Maze procedure at the same operation can be added if you had AF beforehand.
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Stroke risk is 1–3 percent
Mostly from air or debris embolising during the operation. Careful de-airing and epi-aortic scanning keep the risk in that low range.
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Pacemaker is rarely needed
The mitral annulus sits away from the AV node, so the pacemaker rate after mitral surgery is much lower than for aortic surgery - but not zero.
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Sternal precautions if sternotomy
6–8 weeks of no pushing, pulling or lifting more than 5 kg with the arms while the breastbone knits. Mini-mitral avoids this.
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Cardiac rehab is not optional
6–12 weeks of supervised exercise and education after discharge. It measurably improves outcomes and confidence - take the place.
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Red flags after discharge
Fever, spreading redness at the wound, breathlessness at rest, palpitations that will not settle, or new stroke symptoms - call the surgical team or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technique was used - repair or replacement, sternotomy or mini-mitral - the note the surgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and MDT decision
The mechanism of your mitral disease - degenerative MR, functional MR, rheumatic MS, endocarditis - and why surgery was chosen over MitraClip or medical management.
- 02 Technique
Repair or replacement, and approach
What was actually done - annuloplasty ring size, chordal work, resection, or the type of prosthetic valve - and whether it was sternotomy, mini-mitral or robotic.
- 03 Findings
Concomitant procedures and TOE result
Any tricuspid repair, LAA closure, Maze or CABG done at the same time, plus the post-repair TOE showing residual MR (ideally none or trivial).
- 04 Impression
Anticoagulation, rehab, follow-up
Read this first: which anticoagulation you need and for how long, when cardiac rehab starts, and when your next echo and consultant review are booked.
Recognised by major UK insurers
Mitral valve surgery is covered by all major UK PMI insurers when medically indicated. Pre-authorisation is arranged with your case manager before admission. We confirm cover before booking.
Frequently asked
Everything we get asked about mitral valve surgery.
Quick answers on repair vs replacement, mechanical vs tissue, mini-mitral vs sternotomy, cost, and recovery.
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Is mitral repair really better than replacement?
For degenerative MR - prolapse, flail, Barlow’s - yes. Repair preserves your own valve, avoids lifelong warfarin, and gives better 10- and 20-year survival. That is why we send you to a surgeon whose repair rate is over 85 percent, not one who reaches for a prosthesis. For rheumatic and endocarditis cases repair is less often possible.
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Mechanical valve or tissue valve - which should I choose?
A mechanical valve lasts 30+ years but commits you to lifelong warfarin with INR 2.5–3.5 and a 2–3 percent per year bleeding and thromboembolic risk. A tissue valve avoids anticoagulation long-term but wears out at 15–20 years, so 20–30 percent of patients need a redo by then. Younger patients often choose mechanical; older patients, women who may want pregnancy, and warfarin-intolerant patients usually choose tissue.
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What is mini-mitral surgery?
A 5–6 cm incision under the right breast, with cardiopulmonary bypass run through the femoral vessels in the groin. The sternum stays intact, so recovery is faster, cosmesis is better, and sternal precautions are unnecessary. It is now the standard approach at UK high-volume centres - but only when the anatomy and pathology suit it.
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How is this different from MitraClip?
MitraClip is a transcatheter clip delivered via a vein in the groin - no chest opening, no bypass, no general recovery. It is the right answer for many older or high-risk patients with functional MR, and for some primary MR patients unfit for surgery. Surgery still gives the best long-term result in fit patients with degenerative MR. See our MitraClip page for the full comparison.
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How much does private mitral valve surgery cost in the UK?
Roughly £35,000–£55,000 for a mitral repair, £40,000–£60,000 for a replacement or a mini-mitral case, and £50,000–£70,000 for a robotic approach. Add-ons - tricuspid repair, LAA closure, a Maze for AF - cost £4,000–£10,000 each. NHS-funded surgery is free at the point of care. We confirm a firm quote within one working day.
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How long am I in hospital and off work?
5–7 days in hospital after a sternotomy, 4–6 days after a mini-mitral. ITU 24–48 hours. Office work usually resumes at 6–8 weeks; heavier or public-facing jobs 8–12 weeks. Driving 4–6 weeks. Cardiac rehab runs for 6–12 weeks after discharge and is well worth doing properly.
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What are the risks?
Elective mitral surgery in fit patients has an operative mortality of 1–3 percent; endocarditis and redo cases are higher. Specific risks: stroke 1–3 percent, bleeding needing re-operation, post-op AF (30–40 percent), pacemaker (rare after mitral, unlike aortic), infection, kidney impairment, and - for replacements - long-term prosthetic valve endocarditis (0.3–0.5 percent per year) and warfarin-related bleeding for mechanical valves.
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When should this be an emergency?
A flail leaflet, ruptured chordae or acute infective endocarditis can cause sudden severe MR and flash pulmonary oedema - breathlessness at rest, pink frothy sputum, an inability to lie flat. That is A&E, same day, not a clinic booking.
Related treatments
Looking for something else?
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MitraClip
Transcatheter mitral clip - no chest opening.
Learn more -
Heart valve surgery
The full picture across aortic, mitral, tricuspid.
Learn more -
Minimally invasive heart surgery
Mini-thoracotomy and robotic approaches.
Learn more -
Maze procedure
Surgical treatment for atrial fibrillation.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more