Rheumatic Heart Disease Mitral Valve Stenosis: Effective Treatment Options

Rheumatic heart disease is a progressive condition that often leads to complications such as mitral valve stenosis. In the early stages, when the condition is mild and the valve tissue is still in good condition, patients may benefit from less invasive procedures. Initially, a method known as closed commissurotomy was commonly used. However, this has largely been replaced by balloon valvuloplasty, a minimally invasive technique that uses a catheter with a balloon to widen the narrowed valve, effectively restoring proper blood flow.

When Is Surgical Intervention Necessary?

As the disease progresses, the valve may become increasingly fibroted, calcified, or rigid, making it unresponsive to balloon dilation. In such cases, surgical treatment becomes necessary. There are two primary surgical approaches for managing advanced mitral stenosis:

1. Mitral Valve Repair (Valvuloplasty)

Valve repair is often the preferred treatment when possible. With advances in surgical techniques, many patients can now undergo successful mitral valve reconstruction. This procedure aims to restore the normal function of the valve while preserving the patient's own tissue, which can lead to better long-term outcomes and a reduced need for anticoagulation therapy.

2. Mitral Valve Replacement

If the valve damage is too severe for repair, valve replacement may be required. This involves removing the diseased valve and replacing it with either a mechanical valve or a bioprosthetic valve made from animal tissue. The choice between mechanical and biological valves depends on various factors, including the patient's age, lifestyle, and preference for long-term medication use, especially anticoagulants.

Choosing the right treatment option requires a comprehensive evaluation by a cardiologist and cardiac surgeon, ensuring the best possible outcome for each individual patient.