title: Degenerative Mitral Stenosis: Unmet Need for Percutaneous Interventions.
abstract: Degenerative mitral stenosis (DMS) is an important cause of mitral stenosis, developing secondary to severe mitral annular calcification. With the increase in life expectancy and improved access to health care, more patients with DMS are likely to be encountered in developed nations. These patients are generally elderly with multiple comorbidities and often are high-risk candidates for surgery. The mainstay of therapy in DMS patients is medical management with heart rate control and diuretic therapy. Surgical intervention might be delayed until symptoms are severely limiting and cannot be managed by medical therapy. Mitral valve surgery is also challenging in these patients because of the presence of extensive calcification. Hence, there is a need to develop an alternative percutaneous treatment approach for patients with DMS who are otherwise inoperable or at high risk for surgery. In this review, we summarize the available data on the epidemiology of DMS and diagnostic considerations and current treatment strategies for these patients.
authors.affiliation: From Departments of Cardiovascular Medicine (K.S., S.A., M.Q.R., K.P., D.M., L.L.R., A.K., E.M.T., S.R.K.), Internal Medicine (A.P.), and Thoracic and Cardiovascular Surgery (S.L.M., A.M.G.), Cleveland Clinic, OH.
authors.forename: Karan
authors.initials: K
authors.lastname: Sud
authors.affiliation: From Departments of Cardiovascular Medicine (K.S., S.A., M.Q.R., K.P., D.M., L.L.R., A.K., E.M.T., S.R.K.), Internal Medicine (A.P.), and Thoracic and Cardiovascular Surgery (S.L.M., A.M.G.), Cleveland Clinic, OH.
authors.forename: Shikhar
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: From Departments of Cardiovascular Medicine (K.S., S.A., M.Q.R., K.P., D.M., L.L.R., A.K., E.M.T., S.R.K.), Internal Medicine (A.P.), and Thoracic and Cardiovascular Surgery (S.L.M., A.M.G.), Cleveland Clinic, OH.
authors.forename: Akhil
authors.initials: A
authors.lastname: Parashar
authors.affiliation: From Departments of Cardiovascular Medicine (K.S., S.A., M.Q.R., K.P., D.M., L.L.R., A.K., E.M.T., S.R.K.), Internal Medicine (A.P.), and Thoracic and Cardiovascular Surgery (S.L.M., A.M.G.), Cleveland Clinic, OH.
authors.forename: Mohammad Q
authors.initials: MQ
authors.lastname: Raza
authors.affiliation: From Departments of Cardiovascular Medicine (K.S., S.A., M.Q.R., K.P., D.M., L.L.R., A.K., E.M.T., S.R.K.), Internal Medicine (A.P.), and Thoracic and Cardiovascular Surgery (S.L.M., A.M.G.), Cleveland Clinic, OH.
authors.forename: Kunal
authors.initials: K
authors.lastname: Patel
authors.affiliation: From Departments of Cardiovascular Medicine (K.S., S.A., M.Q.R., K.P., D.M., L.L.R., A.K., E.M.T., S.R.K.), Internal Medicine (A.P.), and Thoracic and Cardiovascular Surgery (S.L.M., A.M.G.), Cleveland Clinic, OH.
authors.forename: David
authors.initials: D
authors.lastname: Min
authors.affiliation: From Departments of Cardiovascular Medicine (K.S., S.A., M.Q.R., K.P., D.M., L.L.R., A.K., E.M.T., S.R.K.), Internal Medicine (A.P.), and Thoracic and Cardiovascular Surgery (S.L.M., A.M.G.), Cleveland Clinic, OH.
authors.forename: Leonardo L
authors.initials: LL
authors.lastname: Rodriguez
authors.affiliation: From Departments of Cardiovascular Medicine (K.S., S.A., M.Q.R., K.P., D.M., L.L.R., A.K., E.M.T., S.R.K.), Internal Medicine (A.P.), and Thoracic and Cardiovascular Surgery (S.L.M., A.M.G.), Cleveland Clinic, OH.
authors.forename: Amar
authors.initials: A
authors.lastname: Krishnaswamy
authors.affiliation: From Departments of Cardiovascular Medicine (K.S., S.A., M.Q.R., K.P., D.M., L.L.R., A.K., E.M.T., S.R.K.), Internal Medicine (A.P.), and Thoracic and Cardiovascular Surgery (S.L.M., A.M.G.), Cleveland Clinic, OH.
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Mick
authors.affiliation: From Departments of Cardiovascular Medicine (K.S., S.A., M.Q.R., K.P., D.M., L.L.R., A.K., E.M.T., S.R.K.), Internal Medicine (A.P.), and Thoracic and Cardiovascular Surgery (S.L.M., A.M.G.), Cleveland Clinic, OH.
authors.forename: A Marc
authors.initials: AM
authors.lastname: Gillinov
authors.affiliation: From Departments of Cardiovascular Medicine (K.S., S.A., M.Q.R., K.P., D.M., L.L.R., A.K., E.M.T., S.R.K.), Internal Medicine (A.P.), and Thoracic and Cardiovascular Surgery (S.L.M., A.M.G.), Cleveland Clinic, OH.
authors.forename: E Murat
authors.initials: EM
authors.lastname: Tuzcu
authors.affiliation: From Departments of Cardiovascular Medicine (K.S., S.A., M.Q.R., K.P., D.M., L.L.R., A.K., E.M.T., S.R.K.), Internal Medicine (A.P.), and Thoracic and Cardiovascular Surgery (S.L.M., A.M.G.), Cleveland Clinic, OH. kapadis@ccf.org.
authors.forename: Samir R
authors.initials: SR
authors.lastname: Kapadia
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods*; D006301:Health Services Needs and Demand; D006801:Humans; D008946:Mitral Valve Stenosis / Q000175:diagnosis / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000379:methods*
keywords: calcification, physiologic; mitral valve; mitral valve stenosis