In symptomatic patients with rheumatic heart disease, severe isolated mitral stenosis demands careful evaluation of valve anatomy before selecting an intervention. Most patients can be managed with a less invasive approach, but a subset with specific anatomical features requires a different pathway.
This protocol applies to symptomatic patients with severe isolated rheumatic mitral stenosis. While the majority of such patients are candidates for a less invasive option, those with unfavorable anatomy fall into a distinct management category.
When valve anatomy is unfavorable and the Wilkins score is high, mitral valve surgery becomes the indicated route. The structured protocol defines the criteria for this determination and the recommended surgical approach — the complete pathway is accessible via the link below.
In symptomatic patients with severe isolated rheumatic MS, the low cost and rapid turnaround time associated with BMV compared with open heart surgery make it an attractive option.
Almost 80% of symptomatic patients with severe RHD MS are candidates for BMV, leaving only 20% to undergo surgery because of unfavorable anatomy and high Wilkins score.
DOI: 10.1161/CIR.0000000000000921
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