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Indications for Surgery : The normal mitral valve area is 4-5 cm2. Usually symptoms appear when the valve area has become less than 2.5 cm2. Symptoms are present at rest when the valve area is less than 1.5 cm2. Mitral stenosis is classified as mild, moderate or severe based on: (I) pressure gradient across the valve on echo or cardiac catheterization, (2) calculated valve area.
The ideal operation for mitral stenosis used to be closed mitral valvolomy (CMV). To a large extent this has been replaced by balloon mitral valvotomy (BMV). The indications and suitability of the valve as assessed by echocardiography arc the same for CMV and BMV. The indications for surgery/ invasive procedure have been detailed by American college of cardiology (ACC) and American heart association (AHA) into evidence Class 1, 2A, 2B and 3.
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