Management of mitral stenosis : a systematic review of clinical practice guidelines and recommendations
(2022) In European heart journal. Quality of care & clinical outcomes 8(6). p.602-618- Abstract
A number of guidelines exist with recommendations for diagnosis and management of mitral stenosis (MS). We systematically reviewed existing guidelines for diagnosis and management of MS, highlighting their similarities and differences, in order to guide clinical decision-making. We searched national and international guidelines in MEDLINE and EMBASE (5/4/2011-5/9/2021), the Guidelines International Network, Guideline Library, National Guideline Clearinghouse, National Library for Health Guidelines Finder, Canadian Medical Association Clinical Practice Guidelines Infobase, and websites of relevant organizations. Two independent reviewers screened titles and abstracts, and the full text of potentially relevant articles where needed.... (More)
A number of guidelines exist with recommendations for diagnosis and management of mitral stenosis (MS). We systematically reviewed existing guidelines for diagnosis and management of MS, highlighting their similarities and differences, in order to guide clinical decision-making. We searched national and international guidelines in MEDLINE and EMBASE (5/4/2011-5/9/2021), the Guidelines International Network, Guideline Library, National Guideline Clearinghouse, National Library for Health Guidelines Finder, Canadian Medical Association Clinical Practice Guidelines Infobase, and websites of relevant organizations. Two independent reviewers screened titles and abstracts, and the full text of potentially relevant articles where needed. Selected guidelines were assessed for rigor of development; only guidelines with Appraisal of Guidelines for Research and Evaluation II instrument score >50% were included in the final analysis. Four guidelines were retained for analysis. There was consensus for percutaneous mitral balloon commissurotomy as first-line treatment of symptomatic severe rheumatic MS with suitable anatomy. In patients with unfavourable anatomy, surgical intervention should be considered. Exercise testing is indicated if discrepancy exists between symptoms and echocardiographic measurements. There was no clear divide between rheumatic MS and degenerative MS for their respective diagnoses and management. Pregnancy in severe MS is discouraged and the stenosis should be treated before conception. Long-term antibiotic prophylaxis is recommended for patients with rheumatic MS. Recommendations for the management of patients with mixed valvular diseases are lacking.
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- author
- Galusko, Victor ; Ionescu, Adrian ; Edwards, Amy ; Sekar, Baskar ; Wong, Kit ; Patel, Ketna ; Lloyd, Guy ; Ricci, Fabrizio LU and Khanji, Mohammed Y.
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- guidelines, mitral stenosis, mitral valve, systematic review, valvular heart disease
- in
- European heart journal. Quality of care & clinical outcomes
- volume
- 8
- issue
- 6
- pages
- 17 pages
- publisher
- Oxford University Press
- external identifiers
-
- pmid:34878131
- scopus:85137163910
- ISSN
- 2058-1742
- DOI
- 10.1093/ehjqcco/qcab083
- language
- English
- LU publication?
- yes
- id
- 0759261a-3b54-4e48-91af-8f5729acf22e
- date added to LUP
- 2022-11-14 11:24:39
- date last changed
- 2025-05-01 02:35:49
@article{0759261a-3b54-4e48-91af-8f5729acf22e,
abstract = {{<p>A number of guidelines exist with recommendations for diagnosis and management of mitral stenosis (MS). We systematically reviewed existing guidelines for diagnosis and management of MS, highlighting their similarities and differences, in order to guide clinical decision-making. We searched national and international guidelines in MEDLINE and EMBASE (5/4/2011-5/9/2021), the Guidelines International Network, Guideline Library, National Guideline Clearinghouse, National Library for Health Guidelines Finder, Canadian Medical Association Clinical Practice Guidelines Infobase, and websites of relevant organizations. Two independent reviewers screened titles and abstracts, and the full text of potentially relevant articles where needed. Selected guidelines were assessed for rigor of development; only guidelines with Appraisal of Guidelines for Research and Evaluation II instrument score >50% were included in the final analysis. Four guidelines were retained for analysis. There was consensus for percutaneous mitral balloon commissurotomy as first-line treatment of symptomatic severe rheumatic MS with suitable anatomy. In patients with unfavourable anatomy, surgical intervention should be considered. Exercise testing is indicated if discrepancy exists between symptoms and echocardiographic measurements. There was no clear divide between rheumatic MS and degenerative MS for their respective diagnoses and management. Pregnancy in severe MS is discouraged and the stenosis should be treated before conception. Long-term antibiotic prophylaxis is recommended for patients with rheumatic MS. Recommendations for the management of patients with mixed valvular diseases are lacking.</p>}},
author = {{Galusko, Victor and Ionescu, Adrian and Edwards, Amy and Sekar, Baskar and Wong, Kit and Patel, Ketna and Lloyd, Guy and Ricci, Fabrizio and Khanji, Mohammed Y.}},
issn = {{2058-1742}},
keywords = {{guidelines; mitral stenosis; mitral valve; systematic review; valvular heart disease}},
language = {{eng}},
number = {{6}},
pages = {{602--618}},
publisher = {{Oxford University Press}},
series = {{European heart journal. Quality of care & clinical outcomes}},
title = {{Management of mitral stenosis : a systematic review of clinical practice guidelines and recommendations}},
url = {{http://dx.doi.org/10.1093/ehjqcco/qcab083}},
doi = {{10.1093/ehjqcco/qcab083}},
volume = {{8}},
year = {{2022}},
}