Document Type : Case Report

Authors

Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran.

Abstract

Percutaneous transmitral commissurotomy (PTMC) for treating severe mitral valve stenosis with the Inoue balloon is an interventional procedure performed worldwide. Percutaneous transvenous mitral commissurotomy is the preferred treatment for rheumatic valvular mitral stenosis if the valve has a suitable anatomy. Following trans-septal puncture, entry into the left ventricle is challenging, particularly in patients with large atria. We herein describe a 61-year-old woman with mitral stenosis. Having failed to cross the mitral valve with the standard technique, we utilized a novel over-the-curved spring wire simultaneously with the reverse-loop entry technique to cross the mitral valve. We succeeded in performing a valvotomy with no complications. PTMC, still the preferred treatment for isolated mitral stenosis, consists of 2 steps: trans-septal puncture and balloon crossing into the left ventricle. Nonetheless, an altered left atrial and septal anatomy can make the latter step challenging. High operator experience and various maneuvers and techniques can increase the procedural success rate, even in difficult cases. (Iranian Heart Journal 2023; 24(4): 76-78)

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