Mitral valve stenosis Y descent seen on the wedge tracings. If a trans-septal puncture is made during right heart catheterization, however, the pressure gradient can accurately quantify the severity of mitral stenosis. Chest X-ray may also assist in diagnosis, showing left atrial enlargement. Electrocardiography may show "P mitrale", that is, broad, notched P waves in several or many leads with a prominent late negative component to the P wave in lead V, and may also be seen in mitral regurgitation, and, potentially, any cause of overload of the left atrium. Thus, "P-sinistrocardiale" may be a more appropriate term. Treatment is not necessary in
Mitral valve annuloplasty are believed to be key to optimize leaflet coaptation and to minimize tissue stresses. The challenge of mitral valve annuloplasty is to improve the diseased and distorted shape of the mitral valve and to reestablish the physiological configuration, while preserving normal annular dynamics. Today, cardiac surgeons can select from a variety of annuloplasty devices, flexible, semi-rigid, or rigid, incomplete or complete, planar or saddle-shaped, adjustable and non-adjustable. While the general goal of all devices is the same, namely to increase leaflet coaptation and to support the posterior annulus against dilation, flexible bands are designed to maintain the three-dimensional contour of