A 32-year-old woman with severe rheumatic mitral stenosis (MVA 0.9 cm²) presents with NYHA Class III dyspnoea. Echocardiography shows a Wilkins score of 6, no left atrial thrombus, and no mitral regurgitation. She is in sinus rhythm. What is the definitive treatment of choice?
- A Percutaneous balloon mitral valvuloplasty ✓
- B Surgical mitral valve replacement
- C Surgical closed commissurotomy
- D Medical management with diuretics and beta-blockers
Correct answer: A. Percutaneous balloon mitral valvuloplasty
Explanation
Percutaneous balloon mitral valvuloplasty (PBMV) is the treatment of choice for symptomatic severe mitral stenosis with favourable valve morphology (Wilkins score ≤8), no LA thrombus, and no significant mitral regurgitation. The Wilkins score assesses leaflet mobility, thickening, calcification, and subvalvular disease (each graded 1-4; total ≤8 is favourable). PBMV is preferred over surgery in suitable candidates.
Reference: Braunwald's Heart Disease, 12th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.