ABSTRACT
Medical management of mitral stenosis includes diuretics, control of heart rate, and rheumatic fever prophylaxis. However, a symptomatic patient with hemodynamically significant mitral stenosis (mitral valve area < 1.5 cm2) needs some catheter based or surgical intervention. Catheter or surgical interventions aim at providing a competent and non-obstructed mitral valve. Morphology of the mitral valve, presence or absence of left atrial thrombus/clot, degree of concomitant mitral regurgitation, and associated other cardiac lesions decide the type of intervention. Catheter based balloon mitral valvotomy (BMV) or percutaneous trans-venous mitral commissurotomy (PTMC) is the primary modality of choice. The surgical options include either a closed mitral valvotomy (CMV), open mitral commissurotomy (OMC), or mitral valve replacement (MVR). This chapter describes the surgical aspects of acquired mitral stenosis, excluding congenital mitral stenosis. The etiology, pathophysiology, diagnosis, and decision making has been discussed in separate chapters.
