A 6-year-old child with rheumatic heart disease and severe mitral stenosis (valve area 0.8 cm²) presents with worsening dyspnea and orthopnea. Which of the following is the definitive management?
- A Percutaneous balloon mitral valvuloplasty ✓
- B Mitral valve replacement with a mechanical prosthesis
- C Open surgical commissurotomy
- D Diuretic therapy and rate control
Correct answer: A. Percutaneous balloon mitral valvuloplasty
Explanation
Percutaneous balloon mitral valvuloplasty is the definitive treatment for symptomatic severe mitral stenosis with suitable valve morphology (pliable, non-calcified valve with minimal subvalvular disease). It is the preferred intervention in children with rheumatic mitral stenosis. Mitral valve replacement is reserved for cases not amenable to valvuloplasty. Open surgical commissuromy is rarely performed now. Diuretics are palliative, not definitive.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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