Table 4 Native valve follow-up: mitral stenosis and mitral regurgitation*
Mitral stenosis | ||
|---|---|---|
Mild | Moderate | Severe |
• Valve area > 1.5 cm2 • TTE every 3–5 years | • Valve area: 1.0–1.5 cm2 • TTE every 1–2 years • Cardiologist review | • Valve area: < 1.0 cm2 • TTE every 6–12 months • Cardiologist review |
N.B. Valve area < 1.5 cm2 = clinically significant mitral stenosis where valve intervention can be considered if patient is symptomatic or, asymptomatic with high risk of embolism/decompensation or, positive exercise stress echocardiography | ||
TTE alerts for urgent Cardiologist review: • PA systolic pressure > 50 mmHg • RV dysfunction • Dense spontaneous contrast in the LA | ||
Other alerts for Cardiologist review: • Development of symptoms • New AF • TIA or stroke | ||
Mitral regurgitation | ||
|---|---|---|
Mild | Moderate | Severe |
• TTE every 3–5 years if mild prolapse • No follow up usually required if normal mitral valve appearance | • TTE every 1–2 years • Cardiologist review | • TTE every 6–12 months • Cardiologist review at 6 months |
TTE alerts for urgent Cardiologist review: • LVEF < 60% • LV systolic dimension approaching 45 mm • Severe LV volume dilatation • MR secondary to flail leaflet • PA systolic pressure > 50 mmHg • Severe MR with LA volume ≥ 60 ml/m2 and patient in sinus rhythm | ||
Other alerts for Cardiologist review: • Development of symptoms • New AF | ||