This review summarizes the evidence describing functional mitral stenosis (MS) following surgical mitral valve repair.
Functional MS is an evolving concept and has been implicated in the repair of functional and organic mitral regurgitation. Following repair of functional mitral regurgitation, an elevation in peak transmitral gradient and pulmonary artery pressure has been observed under physiologic stress. These changes have been associated with worse functional status early after restrictive annuloplasty. Following repair of organic mitral regurgitation, functional MS has also been observed and appears associated with worse functional status late after surgery.
Because repair of functional mitral regurgitation commonly involves restrictive annuloplasty, the issue of functional MS must be weighed against the benefits and durability of repair. Functional MS following repair of degenerative mitral regurgitation, however, may be modifiable. Research evaluating various repair techniques and their impact on functional MS following repair of organic is ongoing.
aDivision of Cardiac Surgery
bSchool of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa
cKeenan Research Centre for Biomedical Science
dLi Ka Shing Knowledge Institute of St Michael's Hospital
eDivision of Cardiac Surgery, St Michael's Hospital
fDepartment of Surgery, University of Toronto, Toronto, Ontario, Canada
Correspondence to Dr Vincent Chan, MD, MPH, FRCSC, Cardiac Surgeon, University of Ottawa Heart Institute, 3405, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada. Tel: +1 613 761 4253; fax: +1 613 761 5107; e-mail: firstname.lastname@example.org