Should patients with mitral stenosis who are acceptable surgical commissurotomy candidates now have balloon valvuloplasty treatment?

This review of the surgical and valvuloplasty literature demonstrates that mitral valve morphology rather than the type of intervention determines the therapeutic results after surgical commissurotomy or balloon valvuloplasty treatment of mitral stenosis. The mechanism of dilatation and hemodynamic results of transventricular mitral commissurotomy and of mitral balloon valvuloplasty are similar. Both techniques should be considered palliative. Because the balloon catheter technique can achieve hemodynamic results similar to surgery and may delay the trauma and expense of surgery, it can be offered to patients as a primary treatment for relief of symptomatic mitral stenosis.