Percutaneous balloon valvuloplasty should be applied carefully in patients with prior surgical valvotomy due to the risk of severe mitral valve disruption and massive regurgitation.
May warrant procedural caution in re-do mitral stenosis; hypothesis-generating for complication rates in larger cohorts.
Two cases of massive mitral regurgitation due to mitral valve disruption following percutaneous balloon valvuloplasty are reported. This severe complication occurred in two elderly women with recurrent mitral stenosis after previous surgical commissurotomy. Due to their unstable hemodynamic and clinical condition, both patients underwent emergency valve replacement. At surgery, the commissures appeared fused and heavily calcified; the chordae tendineae thickened, shortened, and fused; and the leaflets presented a large tear with sheared edges. Because the technical aspects of both procedures were unremarkable, the anatomic features of the mitral valve seemed to affect the occurrence of severe mitral regurgitation. Percutaneous balloon valvuloplasty should be therefore applied carefully to patients with prior surgical valvotomy, in whom the structural alterations of the mitral apparatus may predispose to severe valvular damage.
No takes yet. Share an insight, caveat, or question.
Ramondo et al. (1990) studied this question.
Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context: