Rheumatic Mitral Valve Disease: Current Surgical Status
Section snippets
Diagnosis
The diagnosis of rheumatic mitral valve disease is made by clinical history, examination, and echocardiography.16, 23 Transthoracic echocardiography enables evaluation of the extent of leaflet and commissural restriction, fusion, and calcification, as well as the severity of stenosis or regurgitation.24, 25, 26, 27, 28, 29, 30, 31, 32
Management
The management of patients with rheumatic mitral valve disease is the same as that for other causes of mitral stenosis or regurgitation. Significant mitral stenosis can be treated by percutaneous balloon mitral valvuloplasty in the absence of significant calcification or regurgitation.33 When this is not possible, surgery is indicated and usually involves mitral valve replacement although commissurotomy can also be performed (Fig 1).34, 35, 36, 37, 38, 39 The involvement of the entire valvular
Conclusion
Rheumatic mitral valve disease continues to be a major problem particularly in the developing world. Mitral valve repair is more challenging and controversial in this condition compared to degenerative mitral valve disease. There is a higher probability of valve replacement compared to valve repair. The durability of mitral valve repair is also limited in this condition due to its progressive nature.
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Cited by (26)
Valvular Heart Disease
2022, Practical Cardiology: Principles and ApproachesAnalysis of risk factors and establishment of a risk prediction model for cardiothoracic surgical intensive care unit readmission after heart valve surgery in China: A single-center study
2019, Heart and LungCitation Excerpt :In recent years, several reports have suggested that different risk prediction models should be established on the basis of various risk factors, including different disease causes, lesion sites, and types of cardiac surgery.12,13 Meanwhile, previous studies have shown that risk prediction models used in Western countries are inappropriate for Chinese and some other Asian population.14–17 Considering that genetics, the heterogeneity in racial backgrounds, education, access to medical facilities and the epidemiology of heart valve disease in Chinese population may be different from those of western developed countries,18 it is imperative to establish a suitable risk prediction model for Chinese population.
Diagnostic Pathology: Cardiovascular
2018, Diagnostic Pathology: CardiovascularValvular Heart Disease
2017, Practical CardiologyComparative long-term results of mitral valve repair in adults with chronic rheumatic disease and degenerative disease: Is repair for "burnt-out" rheumatic disease still inferior to repair for degenerative disease in the current era'
2015, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :Rheumatic heart disease is the most common cause of valve disease in the developing nations.19,20 The rheumatic process affects the MV in up to 50% of cases and results in MR, MS, or both.21 Replacement of the diseased MV with a prosthesis is associated with suboptimal preservation of ventricular function, anticoagulation-related complications, and reduced survival.
Transapical mitral valve-in-valve implant: An alternative for high risk and multiple reoperative rheumatic patients
2012, International Journal of Cardiology