Treatment for Mitral stenosis

[sunflower_ca]

45 female, severe MS (area =0.79cm2) with a mean gradient of 23mmHg; mild MR <1+, mild to moderate TR <2+, estimated RV systolic pressure: 48mmHg; Normal LV size and LVEF=57%; Left atrial minor axis: 5.5cm, The mitral valve leaflets appear thickened, but open well, not calcified based TEE by the cardiologist.

Question:
1. Is the "Percutaneous Mitral Balloon Valvotomy 1st choice for the MS patient if the patient is a good candidate?  

2. Does open commissurotomy have a better post operative outcome when compared to the Percutaneous mitral balloon valvotomy?

3. Any suggestions for the hospitals and Doctors who are best on PMBV  procedure?
Thanks

[sunflower_ca]

Thank so much to answer my question.

I checked CCF web site, and found they only did <20 cases Mitral Balloon valvotomy on 2008.  It is trouble me to think why this procedure performed in such low rate?

One of doctor recommend Dr. Palacios who is at Mass General Hospital. Does anyone know him?

http://my.clevelandclinic.org/Documents/heart/2008_Outcomes_PDF%27s/25_Valve_Disease.pdf

[kenkeith]

Balloon valvotomy successfully opens the narrowed valve and improves the overall function of the heart. If balloon valvotomy can not be performed, surgical valve repair or replacement may be options. Balloon valvotomy is used to increase the opening of a narrowed (stenotic) valve.
If it valvotomy can be performed, it would be the best option.

Cleveland Clinic and Mayo Clinic are the very best.  The doctors/ssurgeon have best successful outcome and have the best techology availabe.  I can't provide a specific doctor but you can google the Clinics and contact for questions by email.