Mitral valve stenosis is a state of relatively of fi
xed cardiac output.Normal mitral valve area is 4 to 5cmsq. Symptoms with
exercise seen with valve area of less than 2.5cmsq.Symptoms at rest are expected at area of 1.5 or less.Severe stenosis is are
less than 1cmsq.
Goal is to defi
ne the severity of disease.2D echo and color doppler are method used .Allows noninvasive
evaluation and decrease need for cardiac catheterization.
Aim is to avoid cardiac decompsation.Symptoms of other fi
ndings should be reported promptly.Avoid maternal
tachycardia, restrict physical activity
B ?Blockers used empirically to prevent the tacycardia .AF can be managed with digoxin or cardioversion
.Serial echoes are used to follow cardiac function objectively
Surgical commissurotomy is the traditional modality.
Percutaneous mitral valve commissurotomy is prefered alternative.Closed mitral valvotomy is another option
ective as surgical approach,Less invasive,Less expansive,Prefered as fi
rst line in prenatel period.
Indications severe sysmptomatic mitral stenosis .Refractory pulmonary oedema despite medical management
Factors to be evaluated Echocardiographicaly:
Valvular rigidity, valvular calcifi
cation, valvular thickening, amount of subvalvular disease, four factors are evaluated from 0 to
4 depending on severity.
Evidence of left
atrial thrombus,Severe dilation of arotic root,Th
Rotational abnormalities of heart,Th
ickning of atrial septum>4mm.Recent thromboembolic event,Left
ventricular thrombus ,
Relative Severe mitral valve calcifi
cation,Severe subvalvular fi
Best time to perform Before pregnency ,During 2
er attaing the period of viability
Complications Mitral regurgitation.Complications associated with trans septal puncture.
Uncomplicated procedure.Yielding MVA of 1.5cmsq or more.Or 40% increase in MVA.Immediate post op MR grade less than
I have done my MBBS,Post graduation in obstetrics and gynaecology from Maharishi Dayanand University and am presently workin
g as a
consultant in PGIMER,Chandigarh.Looking after cardio obstetric clinic is my area of interest. I have more than 30 publications
in national and
international journals,Life member of many societies.
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