Table 5Current recommendations for surgical therapy

Current recommendations for surgical therapy
Percutaneous valvotomyNYHA class II–IV symptoms, MVA <1.5 cm2, and no LA thrombus or MR
Asymptomatic patients, MVA ≤ 1.5 cm2, pulmonary hypertension (>50 mm Hg), and no LA thrombus or MR
NYHA class III–IV symptoms, MVA ≤ 1.5 cm2, and at high surgical risk
MV repairNYHA class III–IV symptoms, MVA ≤ 1.5 cm2, and one of the following:
  • percutaneous valvotomy is not available
  • LA thrombus is resistant to anticoagulation
  • an intraoperative decision on repair versus replacement will be made
MV replacementNYHA class I–II symptoms, MVA ≤ 1 cm2, and severe pulmonary hypertension (>60 mm Hg)
NYHA class III–IV symptoms, MVA ≤ 1.5 cm2, and not suitable for repair or valvotomy (calcification, fibrosis, subvalvular fusion)

LA: left atrium; MR: mitral regurgitation; MV: mitral valve; MVA: mitral valve area; NYHA: New York Heart Association.

From: Chapter 9, Valve disease

Cover of Cardiology Explained
Cardiology Explained.
Ashley EA, Niebauer J.
London: Remedica; 2004.
Copyright © 2004, Remedica.

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