Key result
Retrograde non trans-septal balloon mitral valvotomy was successfully performed without major complications in a patient with severe mitral stenosis and complex venous anatomy.
Why the study?
Does retrograde non trans-septal balloon mitral valvotomy improve transmitral pressure gradient in a patient with severe mitral stenosis and complex venous anatomy?
Case Report (n=1)
Does retrograde non trans-septal balloon mitral valvotomy improve transmitral pressure gradient in a patient with severe mitral stenosis and complex venous anatomy?
Retrograde non trans-septal balloon mitral valvotomy can be successfully performed in patients with severe mitral stenosis and complex venous anomalies precluding standard trans-septal approaches.
A 22-year-old woman with severe mitral stenosis was referred to us for further evaluation and management. She was found to have severe mitral stenosis, severe tricuspid regurgitation with dilated right atrium and right ventricle with persistent left superior vena cava and hugely dilated coronary sinus. Valve was suitable for balloon mitral valvotomy. Cardiac catheterization showed interrupted inferior vena cava with azygos continuation to right atrium and large left superior vena cava draining to coronary sinus which was very much dilated. Right trans-jugular approach was tried for balloon mitral valvotomy, but was unsuccessful due to a very large right atrium and coronary sinus. Retrograde non trans-septal approach was used and balloon valvotomy was done successfully using a 24 mm × 40 mm TYSHAK balloon without any major complication. Reduction in the transmitral pressure gradient on cardiac catheterization data and transthoracic echocardiography confirmed successful procedure. Balloon mitral valvotomy can be done successfully in patients with the above unusual cardiac anatomy with no major procedural complications.
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Nath et al. (2015) conducted a case report in Severe mitral stenosis with interrupted inferior vena cava, left superior vena cava, and hugely dilated coronary sinus (n=1). Retrograde non trans-septal balloon mitral valvotomy was evaluated on Reduction in transmitral pressure gradient and successful procedure without major complications. Retrograde non trans-septal balloon mitral valvotomy was successfully performed without major complications in a patient with severe mitral stenosis and complex venous anatomy.
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