ABSTRACT
The prevalence of mitral valve disease, especially mitral regurgitation (MR), is increasing. Despite significant gains in the eradication of rheumatic fever, rheumatic mitral stenosis (MS) remains a health care concern in many developing countries. The most common cause of MS is rheumatic heart disease. Less commonly, congenital MS may be detected in children. Clinical manifestations of MS are caused by increased left atrial pressure, atrial fibrillation, or increased pulmonary pressures. Surgical options for MS include closed commissurotomy, open commissurotomy, and mitral valve replacement (MVR). Closed commissurotomy is rarely indicated or performed in developed countries. Patient selection is the most critical step in the success of the procedure. Patients with asymmetric commissural calcification, severe subvalvular scarring, significant MR, and significant tricuspid regurgitation are not ideal candidates for balloon mitral valvotomy (BMV). BMV is the treatment of choice for patients with severe symptomatic MS with favorable valvular anatomy.
