Mitral Valve Stenosis: When Surgery Becomes Necessary

Mitral valve stenosis is a condition that affects the heart's ability to pump blood efficiently. Whether or not surgery is required depends on the severity of the condition and the presence of symptoms. In general, there are several key scenarios in which surgical intervention may be necessary.

1. Moderate to Severe Stenosis with Symptoms

Patients with moderate to severe mitral stenosis who experience symptoms such as shortness of breath, fatigue, or irregular heartbeat are often advised to undergo mitral valve replacement surgery. These symptoms typically indicate that the valve has become significantly narrowed, restricting blood flow and affecting the heart's overall function.

2. Presence of Blood Clots or Atrial Fibrillation

If a patient has developed blood clots in the left atrium or suffers from atrial fibrillation alongside mitral stenosis, it is often necessary to perform both mitral valve replacement and thrombectomy (clot removal). Failing to address the clot can lead to serious complications, including stroke or systemic embolism.

3. Infective Endocarditis Complications

When mitral stenosis is accompanied by infective endocarditis, the infection can cause the formation of vegetations on the valve. In such cases, surgery involves removing the infected tissue, repairing the valve leaflets if possible, and replacing the mitral valve if necessary to restore proper heart function and prevent further complications.

4. Severe Structural Damage or Combined Valve Issues

In cases where the mitral valve structure is severely compromised—such as fused commissures, shortened chordae tendineae, or extreme narrowing—valve replacement is often the best option. Additionally, if a patient has previously undergone surgery for mitral regurgitation and the valve has deteriorated again, a mitral valve replacement may be required to ensure long-term stability and improved quality of life.

Conclusion

Deciding whether to proceed with surgery for mitral valve stenosis requires a thorough evaluation by a cardiologist and cardiac surgeon. Factors such as symptom severity, structural damage, and associated complications all play a role in determining the most appropriate treatment plan. Early diagnosis and timely intervention can significantly improve outcomes and help patients lead healthier lives.