Rheumatic Mitral Valve Stenosis: Diagnosis and Treatment Options

Current Cardiology Reports
Nina C WunderlichRobert J Siegel

Abstract

This review provides an update on rheumatic mitral stenosis. Acute rheumatic fever (RF), the sequela of group A β-hemolytic streptococcal infection, is the major etiology for mitral stenosis (MS). While the incidence of acute RF in the Western world had substantially declined over the past five decades, this trend is reversing due to immigration from non-industrialized countries where rheumatic heart disease (RHD) is higher. Pre-procedural evaluation for treatment of MS using a multimodality approach with 2D and 3D transthoracic and transesophageal echo, stress echo, cardiac CT scanning, and cardiac MRI as well as hemodynamic assessment by cardiac catheterization is discussed. The current methods of percutaneous mitral balloon commissurotomy (PMBC) and surgery are also discussed. New data on long-term follow-up after PMBC is also presented. For severe rheumatic MS, medical therapy is ineffective and definitive therapy entails PMBC in patients with suitable morphological mitral valve (MV) characteristics, or surgery. As procedural outcomes depend heavily on appropriate case selection, definitive imaging and interpretation are crucial. It is also important to understand the indications as well as morphological MV characteristics ...Continue Reading

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Citations

Apr 22, 2020·Journal of Intensive Care Medicine·Jacob C JentzerCharanjit Rihal
Nov 17, 2020·Future Cardiology·Constantinos ZervidesKassem K Sifeldeen
Nov 18, 2020·Clinical Medicine : Journal of the Royal College of Physicians of London·Raja Ef Raja ShariffSazzli S Kasim
Jun 9, 2021·Chest·Pannivettum Kuni ShamilShibdas Chakrabarti
Jun 15, 2021·Frontiers in Cardiovascular Medicine·Guangguo FuZhongkai Wu

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