[HSF] rheumatic mitral disease

[erdinç naseri]

Dear all,
 
opinion requested about the following case: 57 y/o  diabetic female,history of mitral valve dis.,NYHA class III,in sinus rhythmwith mild diastolic rumble and early systoliic murmur on auscultation.Echo: mitral valve thickening,posterior leaflet severely restricted but anterior one has good mobility,MVA 1.67 cm2,Mitral gradient peak 20 mmHg -mean 9 mmHg,eccenteric moderate to severe  mitral regurg jet from posteromedial commissure,LA 6.5 cm. 
Planning to do coronary angio followed by mitral repair +/- CABG.
Although my experience of mitral valve repair has been in ischemic mitral insufficiency and rarely myxomatous degeneration from echo it seems an easy task.
any comments
erdinc