AUTHOR=Shabsigh Muhammad , Lawrence Cassidy , Rosero-Britton Byron R. , Kumar Nicolas , Kimura Satoshi , Durda Michael Andrew , Essandoh Michael TITLE=Mitral Valve Stenosis after Open Repair Surgery for Non-rheumatic Mitral Valve Regurgitation: A Review JOURNAL=Frontiers in Cardiovascular Medicine VOLUME=3 YEAR=2016 URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2016.00008 DOI=10.3389/fcvm.2016.00008 ISSN=2297-055X ABSTRACT=

Mitral stenosis (MS) after mitral valve (MV) repair is a slowly progressive condition, usually detected many years after the index MV surgery. It is defined as a mean transmitral pressure gradient (TMPG) >5 mmHg or a mitral valve area (MVA) <1.5 cm2. Pannus formation around the mitral annulus or extending to the mitral leaflets is suggested as the main mechanism for developing delayed MS after MV repair. On the other hand, early stenosis is thought to be a direct result of an undersized annuloplasty ring. Furthermore, in MS following ischemic mitral regurgitation (MR) repair, subvalvular tethering is the hypothesized pathophysiology. MS after MV repair has an incidence of 9–54%. Several factors have been associated with a higher risk for developing MS after MV repair, including the use of flexible Duran annuloplasty rings versus rigid Carpentier–Edwards rings, complete annuloplasty rings versus partial bands, small versus large anterior leaflet opening angle, and anterior leaflet tip opening length. Intraoperative echocardiography can measure the anterior leaflet opening angle, the anterior leaflet tip opening dimension, the MVA and the mean TMPG, and may help identify patients at risk for developing MS after MV repair.