Key result
Novel veno-arterial looping enables successful PTMC in difficult-to-cross rheumatic mitral stenosis.
Why the study?
Inability to cross the mitral valve during PTMC is a significant cause of procedural failure in patients with rheumatic mitral stenosis.
Case Report (n=4)
A novel veno-arterial looping technique can facilitate successful percutaneous transvenous mitral commissurotomy in patients with rheumatic mitral stenosis when standard crossing of the mitral valve fails.
May aid PTMC when standard mitral crossing fails; hypothesis-generating case series requiring prospective validation before wider use.
Percutaneous transvenous mitral commissurotomy (PTMC) using Inoue/Accura balloon is an effective procedure for management of patients with rheumatic mitral stenosis.1 Inability to cross the mitral valve is one of the pertinent reasons for procedural failure. We describe a series of three patients who were tackled with successful PTMC using a novel technique of veno-arterial looping and in the fourth patient we used double loop entry into left ventricle with veno-arterial rail and peripheral balloon dilatation for completing the PTMC. This is first such reported case series in literature to our knowledge.
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Nanjappa et al. (2016) conducted a case report in Rheumatic mitral stenosis (n=4). Percutaneous transvenous mitral commissurotomy (PTMC) using veno-arterial looping was evaluated on Procedural success. A novel technique of veno-arterial looping enabled successful percutaneous transvenous mitral commissurotomy in 4 patients with rheumatic mitral stenosis and difficult valve crossing.
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