Degenerative mitral valve stenosis: Diagnosis and management

Echocardiography. 2019 Oct;36(10):1901-1909. doi: 10.1111/echo.14495. Epub 2019 Oct 6.

Abstract

Mitral stenosis (MS) is a common valvular disease characterized by narrowing of the mitral valve orifice and a reduction in mitral valve area (MVA). While rheumatic MS (RMS) is frequently encountered in young individuals in developing countries, degenerative MS (DMS) is seen in the elderly in developed countries and its prevalence is increasing. DMS is usually a late presentation of mitral annular calcification (MAC). Accurate assessment of MVA in patients with MAC is challenging due to the alterations in the atrial and valvular structures as well as the presence of other comorbidities in this aging population. We will review the epidemiology, etiology, pathophysiology, diagnostic assessment, and management of DMS and compare the findings with RMS. The latest therapeutic approaches, including medical, surgical, and transcatheter valvular interventions, will be discussed.

Keywords: degenerative mitral stenosis; echocardiography; mitral annular calcification; mitral stenosis; valvular disease.

Publication types

  • Review

MeSH terms

  • Echocardiography / methods*
  • Echocardiography, Three-Dimensional
  • Humans
  • Mitral Valve / diagnostic imaging
  • Mitral Valve / physiopathology
  • Mitral Valve / surgery
  • Mitral Valve Stenosis / diagnostic imaging*
  • Mitral Valve Stenosis / physiopathology
  • Mitral Valve Stenosis / surgery*
  • Tomography, X-Ray Computed / methods*