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European Heart Journal 1991 12(Supplement B):95-98; doi:10.1093/eurheartj/12.suppl_B.95
Copyright © 1991 by the European Society of Cardiology.
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© 1991 The European Society of Cardiology

Treatment of mitral stenosis

D. Burckhardt, A. Hoffmann and W. Kiowski

Division of Cardiology, University Hospital Basel/Switzerland

Correspondence: Dieter Burckhartdt, MD, Professor of Cardiology Division of Cardiology, University Hospital Basel, CH-4031 Basel/Switzerland.

In patients with mitral stenosis the need for therapeutic intervention can be assessed by clinical and non-invasive data. Mitral valve replacement is indicated when marked dyspnoea on mild exertion, dyspnoea at rest or pulmonray oedema, haemoptpis, atrial fibrillation, recurrent systemic emboli or right ventricular failure occur in a patient with a mitral valve area of <1·5cm2, as memured by Doppler echocardiography. This treatment will entail life-long anticoagulation in the majoriv of patients.

Closed commissurotomy is no longer considered a valid therapeutic alternative due to its limited success rate but open cormmissurotomy and balloon valvotomy may be performed in patients with no significant calcification of valve cusps and no major concomitant mitral regurgitation. Preservation of the subvalvular apparatus and left ventricular geometry can be comidered the most important advantages of these techniques. More severe chronic symptom are generally required m indication for mitral valve replacement because of the additional long-term imponderabilities imposed by an implanted artrficial device. Therefore, in patienb with mitral stenosis different symptom and clinical findings will eventually lead to different interventions.

Key Words: Mitral stenosis • commissurotomy


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