How I manage mitral stenosis in the neonate and infant

Congenital mitral valve stenosis is rare. Intervention is indicated in the most severe cases only and is determined by the site and mechanism of valvar obstruction. Correction of mitral valve stenosis is attempted in order to improve mitral valve function and delay replacement as early valve replacement is associated with significant mortality and morbidity. Balloon valvuloplasty can be used for isolated mitral valve lesions. In cases of associated left heart lesions such as aortic stenosis or left ventricular outflow tract obstruction, early palliation with single ventricle repair is performed. Newborn mitral valve replacement in the supraannular position remains the last option and typically requires re-replacement. Below we discuss our preferred management strategies for congenital mitral valve stenosis.