Mixed Mitral Stenosis and Regurgitation
The most common cause for a combined lesion is rheumatic, Very rarely; it could be of congenital origin. Regurgitation in a stenotic valve could be iatrogenic either after a balloon valvotonary or closed initral valvotomy. In a mixed lesion, either the stenosis or the regurgitation is the more dominant lesion.
Haemodynamics and natural history depends on the dominant lesion. Indications for surgery also depend on the donlinant lesion. Surgical treatment is often mitral valve replacement as satisfactory repair is difficult to achieve and long-term results unpredictable.