Materiały źródłowe

• #1 Rheumatic mitral stenosis: Overview of management – UpToDate

  https://www.uptodate.com/contents/rheumatic-mitral-stenosis-overview-of-management

  Mitral stenosis (MS) is a progressive condition characterized by mechanical impedance of blood flow across the mitral valve from the left atrium to the left ventricle. This obstruction leads to increases in pressure within the left atrium, pulmonary vasculature, and right ventricle. Most cases of MS are caused by rheumatic heart disease with mitral commissural adhesion, thickened, immobile mitral valve leaflets, fibrosis, thickening, shortening, fusion, and calcification of the chordae tendineae. […] The medical management and indications for intervention for rheumatic MS will be reviewed here. Outcomes and management of patients undergoing percutaneous mitral balloon commissurotomy and mitral valve surgery for MS are discussed separately. […] Evaluation and management of MS may be enhanced by a multidisciplinary heart valve team approach used for a variety of valve conditions. This multidisciplinary approach incorporates clinical evaluation and risk assessment to determine if mitral valve intervention is indicated and to guide the choice of intervention. […] Interventions for MS (percutaneous mitral balloon commissurotomy [PMBC] and mitral valve surgery) in adults are most commonly performed in countries with high prevalence of rheumatic heart disease; valve centers in such settings often have high procedure volume and extensive operator experience.

• #2 Mitral valve stenosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-stenosis/diagnosis-treatment/drc-20353165

  Treatment for mitral valve stenosis may include: […] Medicine. […] Valve repair or replacement surgery. […] Open-heart surgery. […] If you have mild to moderate mitral valve stenosis with no symptoms, you might not need immediate treatment. Instead, you need regular health checkups to see if your condition gets worse. […] A doctor trained in heart disease typically provides care for people with mitral valve stenosis. This type of doctor is called a cardiologist. […] Medicines are used to reduce the symptoms of mitral valve stenosis. They may include: […] Diuretics, also called water pills, to reduce fluid buildup in the lungs or other areas of the body. […] Blood thinners, called anticoagulants, to help prevent blood clots if you have an irregular heartbeat called atrial fibrillation (AFib).

• #3 Mitral valve stenosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-stenosis/diagnosis-treatment/drc-20353165

  Treatment for mitral valve stenosis may include: […] Medicine. […] Valve repair or replacement surgery. […] Open-heart surgery. […] If you have mild to moderate mitral valve stenosis with no symptoms, you might not need immediate treatment. Instead, you need regular health checkups to see if your condition gets worse. […] A doctor trained in heart disease typically provides care for people with mitral valve stenosis. This type of doctor is called a cardiologist. […] Medicines are used to reduce the symptoms of mitral valve stenosis. They may include: […] Diuretics, also called water pills, to reduce fluid buildup in the lungs or other areas of the body. […] Blood thinners, called anticoagulants, to help prevent blood clots if you have an irregular heartbeat called atrial fibrillation (AFib).

• #4 Mitral valve stenosis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-stenosis/symptoms-causes/syc-20353159

  Mitral valve stenosis can be caused by a complication of strep throat called rheumatic fever. Rheumatic fever is now rare in the United States. […] Treatment for mitral valve stenosis may include medicine or mitral valve repair or replacement surgery. Some people only need regular health checkups. Treatment depends on how severe the valve disease is and whether it’s getting worse. Untreated, mitral valve stenosis can lead to serious heart complications. […] Mitral valve stenosis that is not treated can lead to complications such as irregular heartbeats. Irregular heartbeats are called arrhythmias. Mitral valve stenosis may cause an irregular and chaotic heart rhythm called atrial fibrillation. It’s commonly known as AFib. AFib is a common complication of mitral stenosis. The risk increases with age and more-severe stenosis.

• #5 Mitral Stenosis | Doctor

  https://patient.info/doctor/mitral-stenosis-pro

  Mitral stenosis occurs when there is obstruction to flow through the mitral valve separating the left atrium and left ventricle of the heart. […] The National Institute for Health and Care Excellence (NICE) recommends: Consider echocardiographic assessment every three to five years for adults with mild mitral stenosis. Consider a beta-blocker for adults with moderate to severe mitral stenosis and heart failure. Consider transcatheter valvotomy for adults with rheumatic severe mitral stenosis, if the valve is suitable for this procedure. Offer surgical mitral valve replacement to adults with rheumatic severe mitral stenosis if transcatheter valvotomy is unsuitable. […] Diuretics or long-acting nitrates can be used to alleviate dyspnoea. Beta-blockers can improve exercise tolerance. Anticoagulant therapy is indicated in patients with either permanent or paroxysmal atrial fibrillation. In patients with sinus rhythm, anticoagulation is indicated when there has been prior embolism, or a thrombus is present in the left atrium. […] Percutaneous mitral commissurotomy (PMC): Symptomatic patients with severe mitral stenosis or those with pulmonary hypertension should be considered for PMC. […] Surgical valve replacement should be considered for patients who are not candidates for percutaneous intervention.

• #6

  https://www.singhealth.com.sg/patient-care/conditions-treatments/mitral-valve-stenosis

  Patients with mild to moderate mitral valve stenosis and no symptoms might not need immediate treatment. Instead, the doctor will monitor the mitral valve to check if the condition worsens. […] Currently, there is no medication available that can correct a mitral valve defect. However, certain medicines can help reduce symptoms of mitral valve stenosis. These medication include: […] For some cases, valve repair or valve replacement is necessary. The treatment options include surgical methods (mitral valve repair or replacement) or less-invasive methods such as percutaneous transmitral commissurotomy (PTMC).

• #7 Mitral Stenosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430742/

  Mitral valve stenosis treatment involves medical therapy, percutaneous mitral valvuloplasty, and surgical therapy. Currently, no medical therapy can relieve a fixed obstruction of the mitral valve. Medical therapy is focused on preventing endocarditis, decreasing new cases of rheumatic fever, improving symptoms, and decreasing the thromboembolic risk. […] Endocarditis prophylaxis should only be given to high-risk patients before dental procedures involving gingival tissue manipulation or perforation of the oral mucosa. High-risk patients are those patients with a prosthetic heart valve or prosthetic material used for valve repair, previous history of infective endocarditis, and cardiac valvuloplasty. […] If the rhythm is normal sinus, medical therapy is used to improve symptoms. Diuretics are utilized to help relieve congestion. Beta-blockers and/or calcium channel blockers help with exertional symptoms associated with elevated heart rate.

• #8 Mitral Stenosis Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/155724-treatment

  The goal of medical treatment for mitral stenosis is to reduce recurrence of rheumatic fever, provide prophylaxis for infective endocarditis, reduce symptoms of pulmonary congestion (eg, orthopnea, paroxysmal nocturnal dyspnea), control the ventricular rate if atrial fibrillation is present, and prevent thromboembolic complications. […] Because rheumatic fever is the primary cause of mitral stenosis, secondary prophylaxis against group A beta-hemolytic streptococci (GAS) is recommended. […] A European study involving 315 patients with rheumatic mitral stenosis showed a significantly slower progression of rheumatic mitral stenosis in patients treated with statins compared with patients not taking statins. […] Initial symptoms of pulmonary congestion can be safely treated by diuretics.

• #9 Mitral valve stenosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-stenosis/diagnosis-treatment/drc-20353165

  Treatment for mitral valve stenosis may include: […] Medicine. […] Valve repair or replacement surgery. […] Open-heart surgery. […] If you have mild to moderate mitral valve stenosis with no symptoms, you might not need immediate treatment. Instead, you need regular health checkups to see if your condition gets worse. […] A doctor trained in heart disease typically provides care for people with mitral valve stenosis. This type of doctor is called a cardiologist. […] Medicines are used to reduce the symptoms of mitral valve stenosis. They may include: […] Diuretics, also called water pills, to reduce fluid buildup in the lungs or other areas of the body. […] Blood thinners, called anticoagulants, to help prevent blood clots if you have an irregular heartbeat called atrial fibrillation (AFib).

• #10 Mitral Stenosis Topic Review

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/mitral-stenosis/treatment

  The initial treatment of mitral stenosis relies on the prevention or early recognition of rheumatic heart disease. Prophylactic penicillin treatment for patients known to have rheumatic heart disease successfully reduces exacerbations and will limit the damage done to the mitral valve. Anticoagulation is of great importance to prevent the formation of a left atrial thrombus and embolic events. Even in the absence of atrial fibrillation, patients with certain risk factors including hypertension or hypercoagulable states should be anticoagulated. Antibiotic prophylaxis before dental procedures and certain surgeries is no longer recommended to prevent bacterial endocarditis unless a prosthetic valve is present. […] Preload reduction with diuretics and salt restriction can relieve symptoms of mitral stenosis if pulmonary hypertension is present. Many patients experience symptoms only when the heart rate is elevated, as tachycardia decreases diastolic filling time significantly. Therefore, the use of beta-blockers can occasionally be beneficial, especially in patients with predominantly exertional symptoms.

• #11 Mitral Valve Stenosis in Animals – Circulatory System – Merck Veterinary Manual

  https://www.merckvetmanual.com/circulatory-system/congenital-and-inherited-anomalies-of-the-cardiovascular-system/mitral-valve-stenosis-in-animals

  Medical management of heart failure, if present, is indicated before consideration of surgical and interventional treatment options […] Medical management of animals with mitral valve stenosis involves use of diuretics and dietary sodium restriction. Excessive diuresis should be avoided, because this can reduce cardiac output severely. Surgical or interventional therapy options include closed commisurotomy (disruption of the stenosis without the use of bypass), open commisurotomy, mitral valve replacement, and balloon valvuloplasty.

• #12 Mitral valve stenosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-stenosis/diagnosis-treatment/drc-20353165

  Beta blockers, calcium channel blockers or other heart medicines to slow the heart rate. […] Medicines for irregular heartbeats. These medicines are called antiarrhythmics. […] Antibiotics to prevent a return of rheumatic fever if that’s what damaged the mitral valve. […] A diseased or damaged mitral valve might eventually need to be repaired or replaced, even if you don’t have valve disease symptoms. If you need surgery for another heart condition, a surgeon might do mitral valve repair or replacement at the same time as that treatment. […] Together you and your healthcare team talk about the best treatment for you. Surgeries and procedures for mitral valve stenosis may include: […] Balloon valvuloplasty. This treatment is done to repair a mitral valve with a narrowed opening. […] Open-heart surgery to repair the valve.

• #13 Mitral Stenosis Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/155724-treatment

  In a randomized crossover study, Saggu et al investigated the comparative efficacy of ivabradine and metoprolol on symptoms, hemodynamics, and exercise parameters in 33 patients with mild-to-moderate mitral stenosis (mitral valve area, 1-2 cm) in normal sinus rhythm. […] Atrial fibrillation is common in mitral stenosis and often leads to a rapid ventricular rate with reduced diastolic filling time and increased left atrial pressure. […] The ventricular rate of atrial fibrillation can be slowed acutely by the administration of intravenous beta-blocker or calcium channel blocker therapy (diltiazem or verapamil). […] In the patient with mild mitral stenosis and recent-onset ( 6 mo) atrial fibrillation, conversion to sinus rhythm can be accomplished with pharmacologic agents or electrical cardioversion.

• #14 Mitral Stenosis Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/155724-treatment

  In a randomized crossover study, Saggu et al investigated the comparative efficacy of ivabradine and metoprolol on symptoms, hemodynamics, and exercise parameters in 33 patients with mild-to-moderate mitral stenosis (mitral valve area, 1-2 cm) in normal sinus rhythm. […] Atrial fibrillation is common in mitral stenosis and often leads to a rapid ventricular rate with reduced diastolic filling time and increased left atrial pressure. […] The ventricular rate of atrial fibrillation can be slowed acutely by the administration of intravenous beta-blocker or calcium channel blocker therapy (diltiazem or verapamil). […] In the patient with mild mitral stenosis and recent-onset ( 6 mo) atrial fibrillation, conversion to sinus rhythm can be accomplished with pharmacologic agents or electrical cardioversion.

• #15 Mitral Stenosis Topic Review

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/mitral-stenosis/treatment

  The initial treatment of mitral stenosis relies on the prevention or early recognition of rheumatic heart disease. Prophylactic penicillin treatment for patients known to have rheumatic heart disease successfully reduces exacerbations and will limit the damage done to the mitral valve. Anticoagulation is of great importance to prevent the formation of a left atrial thrombus and embolic events. Even in the absence of atrial fibrillation, patients with certain risk factors including hypertension or hypercoagulable states should be anticoagulated. Antibiotic prophylaxis before dental procedures and certain surgeries is no longer recommended to prevent bacterial endocarditis unless a prosthetic valve is present. […] Preload reduction with diuretics and salt restriction can relieve symptoms of mitral stenosis if pulmonary hypertension is present. Many patients experience symptoms only when the heart rate is elevated, as tachycardia decreases diastolic filling time significantly. Therefore, the use of beta-blockers can occasionally be beneficial, especially in patients with predominantly exertional symptoms.

• #16 Mitral Stenosis – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/valvular-disorders/mitral-stenosis

  Medical treatment includes diuretics, beta-blockers or rate-limiting calcium channel blockers, and anticoagulants. Effective treatment for more severe disease consists of balloon commissurotomy, surgical commissurotomy, or valve replacement. […] Asymptomatic patients with mitral stenosis require no treatment other than appropriate prophylaxis against rheumatic fever recurrence. […] Mildly symptomatic patients usually respond to diuretics and, if sinus tachycardia or atrial fibrillation is present, to beta-blockers or calcium channel blockers, which can control ventricular rate. […] Anticoagulation with a vitamin K antagonist (not a direct-acting oral anticoagulant [DOAC]) is indicated to prevent thromboembolism if patients have or have had atrial fibrillation, embolism, or a left atrial clot.

• #17 Mitral Stenosis – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/valvular-disorders/mitral-stenosis

  Medical treatment includes diuretics, beta-blockers or rate-limiting calcium channel blockers, and anticoagulants. Effective treatment for more severe disease consists of balloon commissurotomy, surgical commissurotomy, or valve replacement. […] Asymptomatic patients with mitral stenosis require no treatment other than appropriate prophylaxis against rheumatic fever recurrence. […] Mildly symptomatic patients usually respond to diuretics and, if sinus tachycardia or atrial fibrillation is present, to beta-blockers or calcium channel blockers, which can control ventricular rate. […] Anticoagulation with a vitamin K antagonist (not a direct-acting oral anticoagulant [DOAC]) is indicated to prevent thromboembolism if patients have or have had atrial fibrillation, embolism, or a left atrial clot.

• #18 Mitral Valve Stenosis | Columbia Surgery

  https://columbiasurgery.org/conditions-and-treatments/mitral-stenosis

  Diuretics (which remove excess fluid) […] Blood thinners (also called anticoagulants) […] Beta blockers (which help with heart rate and blood pressure) […] Calcium channel blockers (which help control blood pressure) […] Anti-arrhythmic medications (which control rhythm problems, if present).

• #19 Mitral valve stenosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-stenosis/diagnosis-treatment/drc-20353165

  Beta blockers, calcium channel blockers or other heart medicines to slow the heart rate. […] Medicines for irregular heartbeats. These medicines are called antiarrhythmics. […] Antibiotics to prevent a return of rheumatic fever if that’s what damaged the mitral valve. […] A diseased or damaged mitral valve might eventually need to be repaired or replaced, even if you don’t have valve disease symptoms. If you need surgery for another heart condition, a surgeon might do mitral valve repair or replacement at the same time as that treatment. […] Together you and your healthcare team talk about the best treatment for you. Surgeries and procedures for mitral valve stenosis may include: […] Balloon valvuloplasty. This treatment is done to repair a mitral valve with a narrowed opening. […] Open-heart surgery to repair the valve.

• #20 Mitral Stenosis Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/155724-treatment

  In a randomized crossover study, Saggu et al investigated the comparative efficacy of ivabradine and metoprolol on symptoms, hemodynamics, and exercise parameters in 33 patients with mild-to-moderate mitral stenosis (mitral valve area, 1-2 cm) in normal sinus rhythm. […] Atrial fibrillation is common in mitral stenosis and often leads to a rapid ventricular rate with reduced diastolic filling time and increased left atrial pressure. […] The ventricular rate of atrial fibrillation can be slowed acutely by the administration of intravenous beta-blocker or calcium channel blocker therapy (diltiazem or verapamil). […] In the patient with mild mitral stenosis and recent-onset ( 6 mo) atrial fibrillation, conversion to sinus rhythm can be accomplished with pharmacologic agents or electrical cardioversion.

• #21 Mitral Stenosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430742/

  Mitral valve stenosis treatment involves medical therapy, percutaneous mitral valvuloplasty, and surgical therapy. Currently, no medical therapy can relieve a fixed obstruction of the mitral valve. Medical therapy is focused on preventing endocarditis, decreasing new cases of rheumatic fever, improving symptoms, and decreasing the thromboembolic risk. […] Endocarditis prophylaxis should only be given to high-risk patients before dental procedures involving gingival tissue manipulation or perforation of the oral mucosa. High-risk patients are those patients with a prosthetic heart valve or prosthetic material used for valve repair, previous history of infective endocarditis, and cardiac valvuloplasty. […] If the rhythm is normal sinus, medical therapy is used to improve symptoms. Diuretics are utilized to help relieve congestion. Beta-blockers and/or calcium channel blockers help with exertional symptoms associated with elevated heart rate.

• #22 Mitral Valve Stenosis – Hope For Hearts

  https://hopeforhearts.com.au/structural-heart-disease/mitral-valve-stenosis/

  – Medications to control AF: […] – Heart rate […] – Heart rhythm […] – Heart Failure medications: […] – Diuretics […] – Antihypertensives […] Medical management also includes the prevention of endocarditis, which can be considered high risk in patients undergoing dental procedures involving the mucosa and gingival tissue. These patients should be considered for prophylactic antibiotic coverage. […] […] A mitral valve replacement may be indicated in patients with moderate to severe mitral valve stenosis. In some cases, a Mitral Valve Balloon Valvuloplasty can be considered as an interim measure to increase the size of the mitral valve. This procedure may relieve symptoms in some cases but is considered to be a temporising treatment and patients may require further intervention.

• #23 Mitral valve stenosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-stenosis/diagnosis-treatment/drc-20353165

  Beta blockers, calcium channel blockers or other heart medicines to slow the heart rate. […] Medicines for irregular heartbeats. These medicines are called antiarrhythmics. […] Antibiotics to prevent a return of rheumatic fever if that’s what damaged the mitral valve. […] A diseased or damaged mitral valve might eventually need to be repaired or replaced, even if you don’t have valve disease symptoms. If you need surgery for another heart condition, a surgeon might do mitral valve repair or replacement at the same time as that treatment. […] Together you and your healthcare team talk about the best treatment for you. Surgeries and procedures for mitral valve stenosis may include: […] Balloon valvuloplasty. This treatment is done to repair a mitral valve with a narrowed opening. […] Open-heart surgery to repair the valve.

• #24 Mitral Stenosis Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/155724-treatment

  The goal of medical treatment for mitral stenosis is to reduce recurrence of rheumatic fever, provide prophylaxis for infective endocarditis, reduce symptoms of pulmonary congestion (eg, orthopnea, paroxysmal nocturnal dyspnea), control the ventricular rate if atrial fibrillation is present, and prevent thromboembolic complications. […] Because rheumatic fever is the primary cause of mitral stenosis, secondary prophylaxis against group A beta-hemolytic streptococci (GAS) is recommended. […] A European study involving 315 patients with rheumatic mitral stenosis showed a significantly slower progression of rheumatic mitral stenosis in patients treated with statins compared with patients not taking statins. […] Initial symptoms of pulmonary congestion can be safely treated by diuretics.

• #25 Mitral Valve Stenosis Treatment Options | Temple Health

  https://www.templehealth.org/services/conditions/mitral-valve-stenosis/treatment-options

  Depending upon the severity of your mitral valve stenosis, your doctor will suggest that you follow one or more of the following treatment approaches. […] Your doctor may prescribe diuretics to help relieve lung congestion. […] When lifestyle changes and medications are not enough to prevent irreversible heart damage and other complications due to stenosis, your doctor will likely recommend surgery. […] There are several approaches that are used to treat mitral valve stenosis including: […] Guiding a balloon-tipped catheter into the mitral valve and gently inflating it to force open the valve and improve blood flow (balloon valvotomy or valvuloplasty, usually for milder stenosis with no regurgitation or calcification) […] Using a minimally invasive technique to separate fused leaflets, create better openings, remove calcium or other obstructions, or make other valve changes (surgical valvuloplasty and other mitral repairs, usually for those with moderate to severe symptoms)

• #26 Mitral Stenosis Topic Review

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/mitral-stenosis/treatment

  The definitive treatments for mitral stenosis include percutaneous balloon mitral valvotomy (PBMV). In this procedure, a catheter is inserted through the femoral vein into the right heart, then across the interatrial septum into the left atrium, and finally across the stenotic mitral valve. A balloon is then inflated, fracturing the calcium deposits and relieving the stenosis. […] According to the 2020 ACC/AHA Guidelines, PBMV, performed at a comprehensive valve center (CVC), is indicated (recommendation class 1) for: Patients with Stage D mitral stenosis with amenable valve morphology, no thrombus in the left atrium, and mild (below angiographic grade 2+) or no mitral regurgitation. […] Surgical approaches to manage mitral stenosis include closed commissurotomy, open commissurotomy and mitral valve replacement.

• #27 Mitral stenosis – Wikipedia

  https://en.wikipedia.org/wiki/Mitral_stenosis

  Treatment options for mitral stenosis include mitral valve replacement by surgery, and percutaneous mitral valvuloplasty by balloon catheter. […] The indication for invasive treatment with either a mitral valve replacement or valvuloplasty is NYHA functional class III or IV symptoms. […] Another option is balloon dilatation. […] To determine which patients would benefit from percutaneous balloon mitral valvuloplasty, a scoring system has been developed. […] Mitral valvuloplasty is a minimally invasive therapeutic procedure to correct an uncomplicated mitral stenosis by dilating the valve using a balloon. […] With careful patient pre-selection, percutaneous balloon mitral valvuloplasty (PBMV) is associated with good success rates and a low rate of complications. […] Although the immediate results of PBMV are often quite gratifying, the procedure does not provide permanent relief from mitral stenosis. Regular follow-up is mandatory, to detect restenosis.

• #28 Mitral Stenosis Topic Review

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/mitral-stenosis/treatment

  The definitive treatments for mitral stenosis include percutaneous balloon mitral valvotomy (PBMV). In this procedure, a catheter is inserted through the femoral vein into the right heart, then across the interatrial septum into the left atrium, and finally across the stenotic mitral valve. A balloon is then inflated, fracturing the calcium deposits and relieving the stenosis. […] According to the 2020 ACC/AHA Guidelines, PBMV, performed at a comprehensive valve center (CVC), is indicated (recommendation class 1) for: Patients with Stage D mitral stenosis with amenable valve morphology, no thrombus in the left atrium, and mild (below angiographic grade 2+) or no mitral regurgitation. […] Surgical approaches to manage mitral stenosis include closed commissurotomy, open commissurotomy and mitral valve replacement.

• #29 Treatment | SCAI – Seconds Count

  https://www.secondscount.org/condition/mitral-valve-stenosis/treatment

  Mitral valvuloplasty is a non-surgical procedure that may be used to open a narrow mitral valve within the heart, also known as mitral valve stenosis. […] This procedure entails the use of a balloon which is advanced from the femoral vein up to the top right side of the heart and then across the division between the top chambers of the heart (atrial septum). The balloon is then advanced using an x-ray and usually echocardiographic guidance across the mitral valve and inflated. This technique cracks the leaflets of the mitral valve apart in an effort to open the narrowed valve.

• #30 Mitral Stenosis Topic Review

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/mitral-stenosis/treatment

  The definitive treatments for mitral stenosis include percutaneous balloon mitral valvotomy (PBMV). In this procedure, a catheter is inserted through the femoral vein into the right heart, then across the interatrial septum into the left atrium, and finally across the stenotic mitral valve. A balloon is then inflated, fracturing the calcium deposits and relieving the stenosis. […] According to the 2020 ACC/AHA Guidelines, PBMV, performed at a comprehensive valve center (CVC), is indicated (recommendation class 1) for: Patients with Stage D mitral stenosis with amenable valve morphology, no thrombus in the left atrium, and mild (below angiographic grade 2+) or no mitral regurgitation. […] Surgical approaches to manage mitral stenosis include closed commissurotomy, open commissurotomy and mitral valve replacement.

• #31 Mitral stenosis – Wikipedia

  https://en.wikipedia.org/wiki/Mitral_stenosis

  Treatment options for mitral stenosis include mitral valve replacement by surgery, and percutaneous mitral valvuloplasty by balloon catheter. […] The indication for invasive treatment with either a mitral valve replacement or valvuloplasty is NYHA functional class III or IV symptoms. […] Another option is balloon dilatation. […] To determine which patients would benefit from percutaneous balloon mitral valvuloplasty, a scoring system has been developed. […] Mitral valvuloplasty is a minimally invasive therapeutic procedure to correct an uncomplicated mitral stenosis by dilating the valve using a balloon. […] With careful patient pre-selection, percutaneous balloon mitral valvuloplasty (PBMV) is associated with good success rates and a low rate of complications. […] Although the immediate results of PBMV are often quite gratifying, the procedure does not provide permanent relief from mitral stenosis. Regular follow-up is mandatory, to detect restenosis.

• #32 Mitral stenosis: Surgical interventions and investigational approaches in adults – UpToDate

  https://www.uptodate.com/contents/mitral-stenosis-surgical-interventions-and-investigational-approaches-in-adults

  Mitral stenosis (MS) is a condition most commonly caused by rheumatic heart disease and characterized by obstruction of blood flow across the mitral valve (MV) from the left atrium to the left ventricle. […] Medical therapy can alleviate symptoms, but surgical or percutaneous intervention is required to relieve the obstruction to flow. […] Surgical and investigational approaches to management of MS are reviewed here. […] The feasibility of percutaneous or surgical commissurotomy is assessed based upon the type and severity of pathologic change involving the valve and subvalvular apparatus. […] For percutaneous commissurotomy, this is most commonly assessed using the Wilkins score, as discussed separately. Assessment for open MV surgery includes more extensive evaluation of all rheumatic pathology including the leaflets (to determine need for surgical delamination and augmentation with pericardium), commissures, and subchordal/chordal (elongation, splitting, chordal transfer or insertion) and papillary muscle pathologies.

• #33 Mitral Valve Stenosis: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21903-mitral-valve-stenosis

  Recovery time for mitral valve stenosis repair or replacement procedures depends on the method. Surgical methods take the longest. You may need to stay in the hospital for days, and it may be weeks before you recover fully. […] Methods that use a catheter-based approach have much faster recovery times. Most people can go home either the same day or the next day and recover fully in days or a few weeks.

• #34 Mitral stenosis – Wikipedia

  https://en.wikipedia.org/wiki/Mitral_stenosis

  Treatment options for mitral stenosis include mitral valve replacement by surgery, and percutaneous mitral valvuloplasty by balloon catheter. […] The indication for invasive treatment with either a mitral valve replacement or valvuloplasty is NYHA functional class III or IV symptoms. […] Another option is balloon dilatation. […] To determine which patients would benefit from percutaneous balloon mitral valvuloplasty, a scoring system has been developed. […] Mitral valvuloplasty is a minimally invasive therapeutic procedure to correct an uncomplicated mitral stenosis by dilating the valve using a balloon. […] With careful patient pre-selection, percutaneous balloon mitral valvuloplasty (PBMV) is associated with good success rates and a low rate of complications. […] Although the immediate results of PBMV are often quite gratifying, the procedure does not provide permanent relief from mitral stenosis. Regular follow-up is mandatory, to detect restenosis.

• #35 Mitral Stenosis Topic Review

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/mitral-stenosis/treatment

  Mitral valve surgery (commissurotomy preferred) is indicated for: Patients with Stage D mitral stenosis who either have a thrombus in the left atrium or concurrent mitral regurgitation (angiographic grade 2+ or higher), who exhibit severe symptoms (NYHA Functional Class III-IV) and are suitable candidates for surgery.

• #36 Mitral Stenosis – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/valvular-disorders/mitral-stenosis

  Moderate mitral stenosis intervention may be indicated when cardiac surgery is required for other indications. […] Severe mitral stenosis intervention is indicated when any symptoms are present if the valve is suitable for percutaneous balloon commissurotomy. […] Percutaneous balloon commissurotomy is the procedure of choice for younger patients and for patients without heavily calcified valve commissures, subvalvular distortion, LA thrombi, or moderate or severe MR. […] Surgical commissurotomy may be used in patients with severe subvalvular disease, valvular calcification, or LA thrombi. […] Valve replacement is confined to patients with severe morphologic changes that make the valve unsuitable for balloon or surgical commissurotomy. […] Lifelong anticoagulation with warfarin is required in patients with a mechanical valve to prevent thromboembolism.

• #37 Mitral Stenosis Topic Review

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/mitral-stenosis/treatment

  Mitral valve surgery (commissurotomy preferred) is indicated for: Patients with Stage D mitral stenosis who either have a thrombus in the left atrium or concurrent mitral regurgitation (angiographic grade 2+ or higher), who exhibit severe symptoms (NYHA Functional Class III-IV) and are suitable candidates for surgery.

• #38 Mitral Valve Stenosis | Columbia Surgery

  https://columbiasurgery.org/conditions-and-treatments/mitral-stenosis

  Mitral Valve Repair: Mitral valve repair surgery is also called valvuloplasty and is performed using traditional surgical tools. During surgery, a cardiac surgeon may make repairs such as separating fused valve leaflets and removing obstructions on or near the mitral valve. This helps to clear the valve passageway. Surgery may need to be repeated if mitral valve stenosis develops again in the years following. […] Mitral Valve Replacement: Most people with mitral valve stenosis who need surgery will have mitral valve replacement. A cardiac surgeon will remove the narrowed mitral valve and replace it with a mechanical valve or a tissue valve. The procedure involves all the steps of traditional heart surgery such as sternotomy and cardiopulmonary bypass. […] Medications cannot correct a defect in the mitral valve, however, certain drugs can reduce symptoms and prevent further damage by easing the heart’s workload and regulating the heart’s rhythm. Medications for mild to moderate mitral stenosis may include:

• #39

  https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=ue1003

  Surgery. Valve repair surgery (commissurotomy) is typically an open-heart surgery. A surgeon removes calcium deposits and other scar tissue from the valve leaflets to widen the valve. […] Valve replacement surgery might be done if the valve is damaged beyond repair. A mechanical or tissue valve will be used to replace your heart valve. This surgery most often is an open-heart surgery.

• #40 Mitral Stenosis – Treatment abroad

  https://www.gsdinternational.com/conditions/mitral-stenosis

  How is it treated? The goal of treatment is to improve heart function, reduce symptoms and/or avoid possible future complications. In the early stages of the disease, especially in patients with mild to moderate mitral stenosis and modest symptoms, periodic clinical checks are recommended. Although drugs cannot treat the valve defect, medical therapy may be indicated to treat symptoms or prevent complications. Medical therapy may include: diuretics to reduce fluid buildup in the lungs, antithrombotic drugs (anticoagulants) to prevent thrombus formation, beta blockers to reduce heart rate and promote filling of the heart, antiarrhythmics to treat atrial fibrillation or other rhythm disorders, antibiotics to prevent recurrence of rheumatic fever if this is the cause of the valvulopathy. […] Surgery for the treatment of mitral stenosis may be repair or replacement. Both repair and replacement surgery are performed with cardiac arrest and extracorporeal circulation. Surgical options include: Commissurotomy. Surgical procedures may include: a) removal of calcifications that usually alter the profile and thickness of the flaps, occupy the annular tissue, and are responsible for the fusion of the areas where the flaps meet or commissure; b) mobilization of the flaps and subvalvular apparatus; c) eventual reinforcement of the ring (annulus) surrounding the valve by implanting an artificial ring (annuloplasty).

• #41 Mitral valve stenosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-stenosis/diagnosis-treatment/drc-20353165

  Mitral valve replacement. If the mitral valve can’t be repaired, surgery may be done to replace the damaged valve. […] The outlook for people who have a catheter treatment or surgery for mitral stenosis is generally good. But older age, poor health, and a lot of calcium buildup on or around the valves increase the risk of surgery complications. Long-term pulmonary hypertension may worsen the outlook after valve surgery.

• #42 Mitral Stenosis – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/valvular-disorders/mitral-stenosis

  Moderate mitral stenosis intervention may be indicated when cardiac surgery is required for other indications. […] Severe mitral stenosis intervention is indicated when any symptoms are present if the valve is suitable for percutaneous balloon commissurotomy. […] Percutaneous balloon commissurotomy is the procedure of choice for younger patients and for patients without heavily calcified valve commissures, subvalvular distortion, LA thrombi, or moderate or severe MR. […] Surgical commissurotomy may be used in patients with severe subvalvular disease, valvular calcification, or LA thrombi. […] Valve replacement is confined to patients with severe morphologic changes that make the valve unsuitable for balloon or surgical commissurotomy. […] Lifelong anticoagulation with warfarin is required in patients with a mechanical valve to prevent thromboembolism.

• #43 Mitral Valve Stenosis – Hope For Hearts

  https://hopeforhearts.com.au/structural-heart-disease/mitral-valve-stenosis/

  There are two distinctly different replacement valves available, tissue and mechanical valves. A cardiac surgeon will determine which valve is most suitable for each individual patient. The age at which a patient requires a valve replacement may influence the valve choice. […] – Tissue Valves are either Porcine (pig) tissue of Bovine (beef) tissue. These valves are stitched onto a metal frame that is then implanted to replace the diseased valve. They have a 10-15 year life span and may then require replacement. […] – Mechanical Valves are a metal component (usually cobalt) that is also attached to a metal frame and implanted. These valves may require patients to take life long anticoagulation medication due to the potential for blood clot formation. Mechanical valves will most likely last a lifetime for most patients.

• #44 Mitral Valve Stenosis – Hope For Hearts

  https://hopeforhearts.com.au/structural-heart-disease/mitral-valve-stenosis/

  There are two distinctly different replacement valves available, tissue and mechanical valves. A cardiac surgeon will determine which valve is most suitable for each individual patient. The age at which a patient requires a valve replacement may influence the valve choice. […] – Tissue Valves are either Porcine (pig) tissue of Bovine (beef) tissue. These valves are stitched onto a metal frame that is then implanted to replace the diseased valve. They have a 10-15 year life span and may then require replacement. […] – Mechanical Valves are a metal component (usually cobalt) that is also attached to a metal frame and implanted. These valves may require patients to take life long anticoagulation medication due to the potential for blood clot formation. Mechanical valves will most likely last a lifetime for most patients.

• #45 Mitral Valve Stenosis: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/mitral-stenosis

  In some cases, surgery may become necessary. Your doctor may surgically repair your existing mitral valve to make it function properly. If that isn’t possible, your doctor may need to replace your mitral valve with a new one. Your replacement valve may be biological, meaning, it comes from a cow, pig, or human cadaver. Or it may be mechanical, meaning your valve is a man-made device.

• #46 Mitral Valve Disease: Types, Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/23235-mitral-valve-disease

  Percutaneous mitral valve replacement. In some cases where surgery would be high risk and it’s anatomically feasible, surgeons will expand a new valve inside of a diseased mitral valve. […] Talk with your provider about the treatment option that’s best for you. Many factors affect your treatment plan, including: What form of mitral valve disease you have. Your age. Your health history. Your current health condition. Whether you have other heart issues that need to be repaired at the same time. […] Surgeries and procedures to treat mitral valve disease are generally very successful. The risk of complications is low. Possible complications are similar to those for other heart procedures, and include: Arrhythmia. Bleeding. Blood clots. Heart attack. Heart block. Infection. […] Risks vary based on the type of treatment you have and other factors, like whether you have coronary artery disease. Talk with your provider about the risks of your specific surgery or procedure.

• #47 Mitral Stenosis – Treatment abroad

  https://www.gsdinternational.com/conditions/mitral-stenosis

  Valve replacement. In case the commissurotomy is not possible or does not guarantee an optimal and lasting result (valve apparatus extremely calcified in all its components), the replacement of the mitral valve with a prosthesis is indicated: mechanical, robust and durable enough to be considered a permanent solution. […] biological, composed of material of animal origin. This feature, on the one hand, does not require the patient to follow an anticoagulant therapy, but on the other hand, exposes the prosthesis to wear with the possible need for a reoperation. […] The surgical approaches that can be used are different based on the degree of invasiveness: the traditional intervention is the one that is performed with total sternotomy, the so-called minimally invasive approach can be: the minimally invasive right anterior minithoracotomy intervention: it is the most commonly used approach.

• #48 Mitral Stenosis – Treatment abroad

  https://www.gsdinternational.com/conditions/mitral-stenosis

  the minimally invasive intervention in partial sternotomy: it is a technique not commonly used that provides shorter skin incisions and allows to leave intact a part of the sternum. […] The minimally invasive surgery of mini-thoracotomy, compared to total sternotomy, has shown advantages for the patient such as better clinical results, especially on the reduction of postoperative bleeding, reduction of time spent in intensive care and overall hospital stay, with consequent reduction of convalescence time and resumption of normal life after surgery. […] For minimally invasive mitral valve surgery, it is always critical to refer to a center of excellence. […] Non-surgical intervention: percutaneous mitral valvuloplasty: In selected cases (absence of significant calcification of the mitral leaflets, absence of associated significant mitral insufficiency) the technique of percutaneous mitral valvuloplasty can be used. The procedure is completely percutaneous and transcatheter and involves the introduction, through the femoral vein, of a catheter equipped with an inflatable balloon at its end. The catheter is pushed until it reaches the stenotic valve, and the valve is opened by inflating the balloon. In well-selected cases, the procedure is extremely effective in reducing the extent of stenosis and improving symptoms. All possible options and aspects related to each individual patient, however, must be discussed and deepened with the cardiac surgeon before the operation.

• #49 Mitral Valve Disease: Types, Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/23235-mitral-valve-disease

  Mitral valve repair surgery. Most doctors prefer this method over replacement surgery whenever possible. It allows you to keep your valve and avoid some of the complications that come with valve replacement. […] Mitral valve replacement surgery. Sometimes replacing your valve is necessary. Your provider will discuss the benefits and risks with you. […] Minimally invasive mitral valve repair. Minimally invasive methods allow for smaller incisions and a quicker recovery. Methods include a right mini-thoracotomy, partial upper sternotomy and robotically-assisted repair. […] Percutaneous interventions. These catheter-based procedures are often a good fit for people who have an enlarged heart, a weak heart or other health problems. If you have mitral valve regurgitation, you may be a candidate for a MitraClip device. This dime-sized device can be implanted on your mitral valve to help it close better and prevent your blood from flowing backward.

• #50 Mitral Stenosis – Treatment abroad

  https://www.gsdinternational.com/conditions/mitral-stenosis

  the minimally invasive intervention in partial sternotomy: it is a technique not commonly used that provides shorter skin incisions and allows to leave intact a part of the sternum. […] The minimally invasive surgery of mini-thoracotomy, compared to total sternotomy, has shown advantages for the patient such as better clinical results, especially on the reduction of postoperative bleeding, reduction of time spent in intensive care and overall hospital stay, with consequent reduction of convalescence time and resumption of normal life after surgery. […] For minimally invasive mitral valve surgery, it is always critical to refer to a center of excellence. […] Non-surgical intervention: percutaneous mitral valvuloplasty: In selected cases (absence of significant calcification of the mitral leaflets, absence of associated significant mitral insufficiency) the technique of percutaneous mitral valvuloplasty can be used. The procedure is completely percutaneous and transcatheter and involves the introduction, through the femoral vein, of a catheter equipped with an inflatable balloon at its end. The catheter is pushed until it reaches the stenotic valve, and the valve is opened by inflating the balloon. In well-selected cases, the procedure is extremely effective in reducing the extent of stenosis and improving symptoms. All possible options and aspects related to each individual patient, however, must be discussed and deepened with the cardiac surgeon before the operation.

• #51 Mitral Valve Stenosis Causes, Symptoms & Treatment

  https://www.thekeyholeheartclinic.com/services/valve-disorders/mitral-valve2/mitral-stenosis/

  Valve replacement is a good treatment for this type of condition once significant shortness of breath develops. There are a few kinds of surgery that can be used as treatment, including keyhole mitral valve replacement. At the Keyhole London Heart Clinic, we would always recommend a minimally invasive keyhole approach, in order to minimise pain, scarring and recovery time for the patient. […] Our preferred method of treatment is to perform keyhole mitral valve replacement through a small cut between the ribs on the right side of the chest in suitable candidates without cutting or spreading the ribs. Keyhole mitral valve stenosis surgery should only be undertaken by highly skilled surgeons, as it requires very precise surgery. However, keyhole surgery, versus traditional open-heart surgery, means the patient heals in a matter of days rather than in weeks. […] While the mild symptoms may be able to be managed with certain drugs and monitoring, the best course of action for the later stages is keyhole heart surgery.

• #52 Mitral Valve Disease: Types, Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/23235-mitral-valve-disease

  Percutaneous mitral valve replacement. In some cases where surgery would be high risk and it’s anatomically feasible, surgeons will expand a new valve inside of a diseased mitral valve. […] Talk with your provider about the treatment option that’s best for you. Many factors affect your treatment plan, including: What form of mitral valve disease you have. Your age. Your health history. Your current health condition. Whether you have other heart issues that need to be repaired at the same time. […] Surgeries and procedures to treat mitral valve disease are generally very successful. The risk of complications is low. Possible complications are similar to those for other heart procedures, and include: Arrhythmia. Bleeding. Blood clots. Heart attack. Heart block. Infection. […] Risks vary based on the type of treatment you have and other factors, like whether you have coronary artery disease. Talk with your provider about the risks of your specific surgery or procedure.

• #53 Heart valve disease treatment in Tulsa, OK – Oklahoma Heart Institute

  https://oklahomaheart.com/services/heart-valve-disease/

  Transcatheter mitral valve replacement — During this procedure, the provider replaces the mitral valve with an artificial valve. This treatment can be utilized in patients who have previously had mitral valve surgery, or in patients who have mitral valve regurgitation or stenosis. […] Our multidisciplinary team of interventional cardiologists, cardiovascular surgeons and heart imaging specialists offer various services to treat heart valve disease, including: […] Balloon valvuloplasty — During this procedure, a catheter with a small, deflated balloon attached to the tip is guided into the damaged valve. The balloon is then inflated to stretch open the valve opening, allowing more blood to pass through. The balloon is then deflated and guided back out of the body. This is a minimally-invasive treatment option for patients with degenerative valve disease.

• #54 Mitral Valve Stenosis | Heart and Vascular

  https://health.ucdavis.edu/conditions/mitral-valve-stenosis

  The mitral valve surgery for repair or replacement can be performed using minimally invasive approaches. This operation avoids cutting the sternum, but instead uses key-hole incisions between the ribs with camera and robotic-assistance. […] TMVR uses a catheter to insert a new mitral valve in your heart. It is an alternative to open heart surgery. […] The UC Davis Health heart team was the first on the West Coast to perform TMVR by accessing the valve through the femoral (leg) vein. This leading-edge approach is one of the least invasive methods for mitral valve replacement.

• #55 Mitral Valve Stenosis | Heart and Vascular

  https://health.ucdavis.edu/conditions/mitral-valve-stenosis

  The mitral valve surgery for repair or replacement can be performed using minimally invasive approaches. This operation avoids cutting the sternum, but instead uses key-hole incisions between the ribs with camera and robotic-assistance. […] TMVR uses a catheter to insert a new mitral valve in your heart. It is an alternative to open heart surgery. […] The UC Davis Health heart team was the first on the West Coast to perform TMVR by accessing the valve through the femoral (leg) vein. This leading-edge approach is one of the least invasive methods for mitral valve replacement.

• #56 Mitral Valve: Common Diseases and Treatments | Froedtert & MCW

  https://www.froedtert.com/heart-valve-disease/mitral-valve

  This alternative is a less invasive treatment option for certain patients with mitral valve regurgitation who are at high risk or inoperable for open heart surgery. During a TMVr, the MitraClip device is guided within a catheter up a vein in the patients leg to the heart. The MitraClip device, which is smaller than the size of a dime, is then positioned to join or clip together a portion of the leaking mitral valve leaflets, helping to restore normal blood flow through the patients heart. […] For these patients, our team provides transcatheter valve-in-valve or valve-in-ring replacements (TMVR). These less invasive, catheter-based options are available for patients who are at high risk for a second open surgery. During the procedure, a new transcatheter mitral valve is inserted inside the existing prosthetic valve or annuloplasty ring. These procedures, like other minimally invasive procedures, can be performed without a surgical incision and while the patient’s heart is still beating, eliminating the need for the heart-lung machine. Patients often go home one to two days after the procedure.

• #57 Mitral Stenosis Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/155724-treatment

  In a randomized crossover study, Saggu et al investigated the comparative efficacy of ivabradine and metoprolol on symptoms, hemodynamics, and exercise parameters in 33 patients with mild-to-moderate mitral stenosis (mitral valve area, 1-2 cm) in normal sinus rhythm. […] Atrial fibrillation is common in mitral stenosis and often leads to a rapid ventricular rate with reduced diastolic filling time and increased left atrial pressure. […] The ventricular rate of atrial fibrillation can be slowed acutely by the administration of intravenous beta-blocker or calcium channel blocker therapy (diltiazem or verapamil). […] In the patient with mild mitral stenosis and recent-onset ( 6 mo) atrial fibrillation, conversion to sinus rhythm can be accomplished with pharmacologic agents or electrical cardioversion.

• #58 Mitral Valve Stenosis – Hope For Hearts

  https://hopeforhearts.com.au/structural-heart-disease/mitral-valve-stenosis/

  Patients with mitral valve stenosis may require a combination of medical and surgical management as the condition progresses and symptoms are present. Surgical replacement of the diseased valve is the definitive treatment of mitral valve stenosis, however, this may be considered a high-risk procedure and early medical management may assist in the limitation of symptoms. Many patients with mitral valve stenosis may also have other comorbid medical conditions that can subsequently require complex medical management in conjunction with their General Practitioner, Cardiologists and Cardiac Surgeons. […] […] The presence of Atrial Fibrillation (AF) in patients with mitral valve stenosis may require the administration of: […] – Anticoagulants to reduce the risk of clot formation and stroke

• #59 Mitral Stenosis Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/155724-treatment

  PMC is the procedure of choice for patients with uncomplicated mitral stenosis. […] The short- and long-term prognoses are favorable compared with surgical valvotomy. […] Open surgical commissurotomy allows direct visualization of the mitral valve. […] Using current techniques, even severe regurgitant or stenotic valves can often be repaired, with good long-term results. […] Patients who have chronic atrial fibrillation and who undergo mitral valve surgery can have simultaneous Cox Maze procedure or pulmonary vein ablation, which helps to maintain sinus rhythm in up to 80% of the cases during the postoperative period.

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• #62 Mitral Valve Stenosis | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/mitral-valve-stenosis

  Children with more advanced mitral stenosis are likely to require interventional catheterization or valve surgery; however, some don’t need any immediate treatment. […] Your child’s cardiologist will regularly evaluate your child for any sign of further narrowing in the mitral valve and related complications. Most often, routine monitoring will involve physical examinations and echocardiograms. […] Medication is not a cure for mitral valve stenosis but can be helpful in managing specific symptoms. […] Boston Children’s Hospital has a program dedicated to interventional catheterization, the use of a thin tube called a catheter that is threaded from a vein or artery into the heart. […] The most common interventional catheterization procedure used to treat mitral valve stenosis is balloon dilation or balloon valvuloplasty.

• #63 Mitral Valve Stenosis | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/mitral-valve-stenosis

  Children with more advanced mitral stenosis are likely to require interventional catheterization or valve surgery; however, some don’t need any immediate treatment. […] Your child’s cardiologist will regularly evaluate your child for any sign of further narrowing in the mitral valve and related complications. Most often, routine monitoring will involve physical examinations and echocardiograms. […] Medication is not a cure for mitral valve stenosis but can be helpful in managing specific symptoms. […] Boston Children’s Hospital has a program dedicated to interventional catheterization, the use of a thin tube called a catheter that is threaded from a vein or artery into the heart. […] The most common interventional catheterization procedure used to treat mitral valve stenosis is balloon dilation or balloon valvuloplasty.

• #64 Mitral Valve Stenosis | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/mitral-valve-stenosis

  For children with severe mitral stenosis, balloon valvuloplasty may not adequately fix the narrowed valve. […] If valve repair is not possible, cardiac surgeons will remove the damaged mitral valve and replace it with either a mechanical valve or a donor valve taken from a human or animal donor. […] Both types of valve-replacement surgery have an excellent success rate and a low incidence of complications.

• #65 Mitral Valve Stenosis | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/mitral-valve-stenosis

  For children with severe mitral stenosis, balloon valvuloplasty may not adequately fix the narrowed valve. […] If valve repair is not possible, cardiac surgeons will remove the damaged mitral valve and replace it with either a mechanical valve or a donor valve taken from a human or animal donor. […] Both types of valve-replacement surgery have an excellent success rate and a low incidence of complications.

• #66 Mitral Valve Stenosis: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21903-mitral-valve-stenosis

  A surgeon can use many different methods for mitral valve repair, including minimally invasive surgery or robotically assisted surgery. People with mitral valve stenosis from rheumatic heart disease may have a commissurotomy. This separates the areas where your valves flaps fused together or got too thick. […] Depending on your case and your needs, your surgeon may recommend either repairing the valve or replacing it altogether. Your new valve may contain animal tissue, artificial materials or both. Your provider can help you choose the best option. […] Complications of mitral valve stenosis treatment may include: Dizziness, Bleeding, Infection, Heart failure, Heart attack, Stroke, Severe mitral regurgitation (leaky valve), Blood clots, Abnormal heart rhythms, Issues with artificial valves.

• #67 Mitral Valve Disease: Types, Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/23235-mitral-valve-disease

  Percutaneous mitral valve replacement. In some cases where surgery would be high risk and it’s anatomically feasible, surgeons will expand a new valve inside of a diseased mitral valve. […] Talk with your provider about the treatment option that’s best for you. Many factors affect your treatment plan, including: What form of mitral valve disease you have. Your age. Your health history. Your current health condition. Whether you have other heart issues that need to be repaired at the same time. […] Surgeries and procedures to treat mitral valve disease are generally very successful. The risk of complications is low. Possible complications are similar to those for other heart procedures, and include: Arrhythmia. Bleeding. Blood clots. Heart attack. Heart block. Infection. […] Risks vary based on the type of treatment you have and other factors, like whether you have coronary artery disease. Talk with your provider about the risks of your specific surgery or procedure.

• #68 Mitral Valve Stenosis: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21903-mitral-valve-stenosis

  Recovery time for mitral valve stenosis repair or replacement procedures depends on the method. Surgical methods take the longest. You may need to stay in the hospital for days, and it may be weeks before you recover fully. […] Methods that use a catheter-based approach have much faster recovery times. Most people can go home either the same day or the next day and recover fully in days or a few weeks.

• #69 Mitral Valve Stenosis: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21903-mitral-valve-stenosis

  Recovery time for mitral valve stenosis repair or replacement procedures depends on the method. Surgical methods take the longest. You may need to stay in the hospital for days, and it may be weeks before you recover fully. […] Methods that use a catheter-based approach have much faster recovery times. Most people can go home either the same day or the next day and recover fully in days or a few weeks.

• #70 Mitral Valve Stenosis Causes, Symptoms & Treatment

  https://www.thekeyholeheartclinic.com/services/valve-disorders/mitral-valve2/mitral-stenosis/

  Valve replacement is a good treatment for this type of condition once significant shortness of breath develops. There are a few kinds of surgery that can be used as treatment, including keyhole mitral valve replacement. At the Keyhole London Heart Clinic, we would always recommend a minimally invasive keyhole approach, in order to minimise pain, scarring and recovery time for the patient. […] Our preferred method of treatment is to perform keyhole mitral valve replacement through a small cut between the ribs on the right side of the chest in suitable candidates without cutting or spreading the ribs. Keyhole mitral valve stenosis surgery should only be undertaken by highly skilled surgeons, as it requires very precise surgery. However, keyhole surgery, versus traditional open-heart surgery, means the patient heals in a matter of days rather than in weeks. […] While the mild symptoms may be able to be managed with certain drugs and monitoring, the best course of action for the later stages is keyhole heart surgery.

• #71 Mitral valve stenosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-stenosis/diagnosis-treatment/drc-20353165

  Mitral valve replacement. If the mitral valve can’t be repaired, surgery may be done to replace the damaged valve. […] The outlook for people who have a catheter treatment or surgery for mitral stenosis is generally good. But older age, poor health, and a lot of calcium buildup on or around the valves increase the risk of surgery complications. Long-term pulmonary hypertension may worsen the outlook after valve surgery.

• #72 Congenital Mitral Valve Stenosis Treatment | Norton Children’s

  https://nortonchildrens.com/services/cardiology/conditions/treatments/surgical/congenital-mitral-valve-stenosis-treatment/

  Congenital Mitral Valve Stenosis Treatment […] In severe cases, your child may need a valvuloplasty or open heart surgery to fix or replace the valve. […] One potential treatment for mitral valve stenosis is called a balloon valvuloplasty. […] Mitral valve replacement is a more invasive surgery than a balloon valvuloplasty. […] The specialists at Norton Children’s Heart Institute will follow your child after these procedures and be able to provide answers to your questions before you leave the hospital.

• #73 Mitral valve stenosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-stenosis/diagnosis-treatment/drc-20353165

  Mitral valve replacement. If the mitral valve can’t be repaired, surgery may be done to replace the damaged valve. […] The outlook for people who have a catheter treatment or surgery for mitral stenosis is generally good. But older age, poor health, and a lot of calcium buildup on or around the valves increase the risk of surgery complications. Long-term pulmonary hypertension may worsen the outlook after valve surgery.

• #74 Mitral Stenosis Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/155724-treatment

  PMC is the procedure of choice for patients with uncomplicated mitral stenosis. […] The short- and long-term prognoses are favorable compared with surgical valvotomy. […] Open surgical commissurotomy allows direct visualization of the mitral valve. […] Using current techniques, even severe regurgitant or stenotic valves can often be repaired, with good long-term results. […] Patients who have chronic atrial fibrillation and who undergo mitral valve surgery can have simultaneous Cox Maze procedure or pulmonary vein ablation, which helps to maintain sinus rhythm in up to 80% of the cases during the postoperative period.

• #75 Mitral Valve Stenosis Causes, Symptoms, and Treatment

  https://www.upmc.com/services/heart-vascular/conditions/mitral-valve-stenosis

  Your surgeon may recommend valve replacement surgery if your mitral valves cannot be repaired. […] At UPMC, our team performs mitral valve repair procedures every day with a repair success rate of more than 90 percent. Our mitral valve replacement procedures have similar outcomes, with most otherwise healthy patients returning to a normal, active lifestyle after surgery.

• #76 Mitral valve stenosis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-stenosis/symptoms-causes/syc-20353159

  The best way to prevent mitral valve stenosis is to prevent rheumatic fever. You can do this by making sure you and your children see a healthcare professional for sore throats. Untreated strep throat infections can develop into rheumatic fever. Strep throat is usually easily treated with antibiotics.

• #77 Mitral valve stenosis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-stenosis/symptoms-causes/syc-20353159

  The best way to prevent mitral valve stenosis is to prevent rheumatic fever. You can do this by making sure you and your children see a healthcare professional for sore throats. Untreated strep throat infections can develop into rheumatic fever. Strep throat is usually easily treated with antibiotics.

• #78 Mitral valve stenosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-stenosis/diagnosis-treatment/drc-20353165

  Beta blockers, calcium channel blockers or other heart medicines to slow the heart rate. […] Medicines for irregular heartbeats. These medicines are called antiarrhythmics. […] Antibiotics to prevent a return of rheumatic fever if that’s what damaged the mitral valve. […] A diseased or damaged mitral valve might eventually need to be repaired or replaced, even if you don’t have valve disease symptoms. If you need surgery for another heart condition, a surgeon might do mitral valve repair or replacement at the same time as that treatment. […] Together you and your healthcare team talk about the best treatment for you. Surgeries and procedures for mitral valve stenosis may include: […] Balloon valvuloplasty. This treatment is done to repair a mitral valve with a narrowed opening. […] Open-heart surgery to repair the valve.

• #79 Rheumatic mitral stenosis: Overview of management – UpToDate

  https://www.uptodate.com/contents/rheumatic-mitral-stenosis-overview-of-management

  Mitral stenosis (MS) is a progressive condition characterized by mechanical impedance of blood flow across the mitral valve from the left atrium to the left ventricle. This obstruction leads to increases in pressure within the left atrium, pulmonary vasculature, and right ventricle. Most cases of MS are caused by rheumatic heart disease with mitral commissural adhesion, thickened, immobile mitral valve leaflets, fibrosis, thickening, shortening, fusion, and calcification of the chordae tendineae. […] The medical management and indications for intervention for rheumatic MS will be reviewed here. Outcomes and management of patients undergoing percutaneous mitral balloon commissurotomy and mitral valve surgery for MS are discussed separately. […] Evaluation and management of MS may be enhanced by a multidisciplinary heart valve team approach used for a variety of valve conditions. This multidisciplinary approach incorporates clinical evaluation and risk assessment to determine if mitral valve intervention is indicated and to guide the choice of intervention. […] Interventions for MS (percutaneous mitral balloon commissurotomy [PMBC] and mitral valve surgery) in adults are most commonly performed in countries with high prevalence of rheumatic heart disease; valve centers in such settings often have high procedure volume and extensive operator experience.

• #80 Mitral valve disease: when should we call in the cardiac surgeon?

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-16/Mitral-valve-disease-when-should-we-call-in-the-cardiac-surgeon

  Mitral valve repair is preferable to mitral valve replacement. […] Mitral valve surgery is indicated for symptomatic severe primary mitral regurgitation and asymptomatic severe primary mitral regurgitation in patients with signs of left ventricular dysfunction, atrial fibrillation or pulmonary hypertension. […] Mitral valve cases should be discussed by a multidisciplinary Mitral Valve Heart Team to determine the optimal interventional approach.

• #81 Mitral Valve Disease: Types, Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/23235-mitral-valve-disease

  Percutaneous mitral valve replacement. In some cases where surgery would be high risk and it’s anatomically feasible, surgeons will expand a new valve inside of a diseased mitral valve. […] Talk with your provider about the treatment option that’s best for you. Many factors affect your treatment plan, including: What form of mitral valve disease you have. Your age. Your health history. Your current health condition. Whether you have other heart issues that need to be repaired at the same time. […] Surgeries and procedures to treat mitral valve disease are generally very successful. The risk of complications is low. Possible complications are similar to those for other heart procedures, and include: Arrhythmia. Bleeding. Blood clots. Heart attack. Heart block. Infection. […] Risks vary based on the type of treatment you have and other factors, like whether you have coronary artery disease. Talk with your provider about the risks of your specific surgery or procedure.

• #82 Mitral Stenosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430742/

  Mitral valve stenosis treatment involves medical therapy, percutaneous mitral valvuloplasty, and surgical therapy. Currently, no medical therapy can relieve a fixed obstruction of the mitral valve. Medical therapy is focused on preventing endocarditis, decreasing new cases of rheumatic fever, improving symptoms, and decreasing the thromboembolic risk. […] Endocarditis prophylaxis should only be given to high-risk patients before dental procedures involving gingival tissue manipulation or perforation of the oral mucosa. High-risk patients are those patients with a prosthetic heart valve or prosthetic material used for valve repair, previous history of infective endocarditis, and cardiac valvuloplasty. […] If the rhythm is normal sinus, medical therapy is used to improve symptoms. Diuretics are utilized to help relieve congestion. Beta-blockers and/or calcium channel blockers help with exertional symptoms associated with elevated heart rate.

• #83 Mitral Stenosis Topic Review

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/mitral-stenosis/treatment

  The definitive treatments for mitral stenosis include percutaneous balloon mitral valvotomy (PBMV). In this procedure, a catheter is inserted through the femoral vein into the right heart, then across the interatrial septum into the left atrium, and finally across the stenotic mitral valve. A balloon is then inflated, fracturing the calcium deposits and relieving the stenosis. […] According to the 2020 ACC/AHA Guidelines, PBMV, performed at a comprehensive valve center (CVC), is indicated (recommendation class 1) for: Patients with Stage D mitral stenosis with amenable valve morphology, no thrombus in the left atrium, and mild (below angiographic grade 2+) or no mitral regurgitation. […] Surgical approaches to manage mitral stenosis include closed commissurotomy, open commissurotomy and mitral valve replacement.

• #84 Mitral valve disease: when should we call in the cardiac surgeon?

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-16/Mitral-valve-disease-when-should-we-call-in-the-cardiac-surgeon

  Surgery is therefore indicated in asymptomatic patients with LV dysfunction (LVESD 45 mm and/or LVEF 60%, Class I) and in those with preserved LV function (LVESD 45 mm and LVEF 60%) and atrial fibrillation secondary to mitral regurgitation, or pulmonary hypertension (systolic pulmonary pressure at rest 50 mmHg, Class IIa). […] Mitral valve surgery is only indicated for severe mitral stenosis in patients not judged suitable for percutaneous mitral commissurotomy (PMC) by the Heart Team (Class I recommendation) because of unfavourable characteristics or contraindications to PMC that include severe pulmonary hypertension, permanent atrial fibrillation and/or persistent left atrial appendage thrombus, previous commissurotomy, high echocardiographic anatomic scores (Wilkins, Cormier), and concomitant aortic or tricuspid valvular disease or significant coronary artery disease.

• #85 Mitral Valve Stenosis Causes, Symptoms & Treatment

  https://www.thekeyholeheartclinic.com/services/valve-disorders/mitral-valve2/mitral-stenosis/

  Valve replacement is a good treatment for this type of condition once significant shortness of breath develops. There are a few kinds of surgery that can be used as treatment, including keyhole mitral valve replacement. At the Keyhole London Heart Clinic, we would always recommend a minimally invasive keyhole approach, in order to minimise pain, scarring and recovery time for the patient. […] Our preferred method of treatment is to perform keyhole mitral valve replacement through a small cut between the ribs on the right side of the chest in suitable candidates without cutting or spreading the ribs. Keyhole mitral valve stenosis surgery should only be undertaken by highly skilled surgeons, as it requires very precise surgery. However, keyhole surgery, versus traditional open-heart surgery, means the patient heals in a matter of days rather than in weeks. […] While the mild symptoms may be able to be managed with certain drugs and monitoring, the best course of action for the later stages is keyhole heart surgery.

• #86 Mitral Valve Disease: Types, Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/23235-mitral-valve-disease

  Mitral valve repair surgery. Most doctors prefer this method over replacement surgery whenever possible. It allows you to keep your valve and avoid some of the complications that come with valve replacement. […] Mitral valve replacement surgery. Sometimes replacing your valve is necessary. Your provider will discuss the benefits and risks with you. […] Minimally invasive mitral valve repair. Minimally invasive methods allow for smaller incisions and a quicker recovery. Methods include a right mini-thoracotomy, partial upper sternotomy and robotically-assisted repair. […] Percutaneous interventions. These catheter-based procedures are often a good fit for people who have an enlarged heart, a weak heart or other health problems. If you have mitral valve regurgitation, you may be a candidate for a MitraClip device. This dime-sized device can be implanted on your mitral valve to help it close better and prevent your blood from flowing backward.

• #87 Mitral valve stenosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-stenosis/diagnosis-treatment/drc-20353165

  Treatment for mitral valve stenosis may include: […] Medicine. […] Valve repair or replacement surgery. […] Open-heart surgery. […] If you have mild to moderate mitral valve stenosis with no symptoms, you might not need immediate treatment. Instead, you need regular health checkups to see if your condition gets worse. […] A doctor trained in heart disease typically provides care for people with mitral valve stenosis. This type of doctor is called a cardiologist. […] Medicines are used to reduce the symptoms of mitral valve stenosis. They may include: […] Diuretics, also called water pills, to reduce fluid buildup in the lungs or other areas of the body. […] Blood thinners, called anticoagulants, to help prevent blood clots if you have an irregular heartbeat called atrial fibrillation (AFib).

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