Rheumatic Mitral Stenosis
The mitral valve separates the left main pumping chamber of the heart (left ventricle) from left upper chamber of the heart (atrium) and lungs. The mitral valve prevents backward flow of blood. If this valve becomes narrowed over time from degeneration and calcium build up from Rheumatic heart disease, this creates high pressures on the left upper chamber of the heart which increases the pressures in the lungs and right side of the heart. Ultimately this increase in pressure causes increased loading of the right heart and an increase in the lung pressures (pulmonary hypertension). If left unchecked, this will ultimately result in right heart failure and pulmonary hypertension that may be irreversible. Two current treatments exist for correcting the valve narrowing, surgical (open-chest/heart) and catheter-based (nonsurgical). Surgical correction involves open-heart valve replacement, whereas catheter-based treatment usually involves balloon dilation of the mitral valve (balloon mitral valvuloplasty; BMV). Both are safe and effective ways of managing mitral stenosis and both prevent the adverse effects described above. Although surgical correction is a more definitive treatment modality, BMV has a long-term durability and is the treatment of choice in patients presenting early with the appropriate anatomy.