Mitral stenosis

Although the prevalence of rheumatic fever has greatly decreased in Western countries, mitral stenosis (MS) still results in significant morbidity and mortality worldwide. Echocardiography is the main method used to assess the severity and consequences of MS, as well as the extent of anatomic lesions. The treatment of MS has been revolutionized since the development of percutaneous mitral balloon commissurotomy (PMC) Intervention should be performed in symptomatic patients with clinically significant MS (moderate to severe) (valve area <1.5 cm²). Most patients with favourable valve morphology currently undergo PMC. Decision-making in patients with suboptimal anatomy must take into account the multifactorial nature of predicting the results of PMC. PMC is indicated when surgery is contraindicated, conversely surgery is indicated in patients who are unsuitable for PMC. Asymptomatic patients are not usually candidates for PMC, except in cases where there is increased risk of systemic embolism or haemodynamic decompensation.