Balloon mitral valvuloplasty in the elderly

"Scoring" of the valve according to the Wilkins' criteria-calcification, mobility, thickening, and subvalvar involvement-and assessment of commissural calcification can be made, and are good predictors of outcome. 2 3 Transoesophageal echocardiography is mandatory to exclude free atrial thrombus, and provides very clear images of the mitral apparatus. Since the development of transeoesophageal echocardiography therefore, right and left heart catheterisation has become outmoded as a means of assessment of the severity of mitral stenosis. [...]the patient, given the choice, often opts for the less invasive procedure, reasoning that surgery remains an option in the short term if the balloon fails to relieve their symptoms.