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Cardiovascular Disease

What are the indication for surgery in a patient with MS?
Symptomatic patients with moderate to severe MS when
- PMBV is unavailable
- PMBV is contraindicated due to presence of left atrial thrombus despite anticoagulation or because of concomitant moderate to severe MR
- Valve morphology is not favourable for PMBV in a patient with acceptable operative risk
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