Mitral valve replacement after closed mitral valvotomy

Mitral valve replacement after closed mitral valvotomy

What is the most common reason for a patient who has undergone closed mitral valvotomy needing a mitral valve replacement later?

Mitral restenosis with calcification is the common reason for requiring mitral valve replacement later. Other possibilities are inadequate valvotomy and development of progressive mitral regurgitation, which could have developed during the procedure or later on due to recurrence of rheumatic activity.

Closed mitral valvotomy is rather an obsolete procedure now, with the advent of balloon mitral valvotomy, also known as percutaneous transmitral commisurotmy. But the same mechanisms for needing mitral valve replacement later hold good for BMV/PTMC.