How is tx of MS?

Penicillin prophylaxis of group A strep for secondary prevention of RF, infective endocarditis prophylaxis restricted for pt at high risk of complications from infection like pt with hx of endocarditis. Indication for percutaneous mitral commissurectomy and mitral valve surgery in clinically significant mitral stenosis (area <1.5cm2); PMC symptomatic pt w/out unfavorable characteristic for PMC/symptomatic pt with contraindication for high risk surgery. Mitral valve surgery in symptomatic pt not suitable for PMC in absence of futility