A case of percutaneous mitral balloon valvuloplasty complicated by pericardial effusion and thrombus formation on the interatrial septum

Abstract

Percutaneous mitral balloon valvuloplasty (PMBV) is the primary treatment in mitral stenosis patients with appropriate valve anatomy with no contraindications present. Pericardial effusion, cardiac tamponade and thrombus formation are rare but serious complications of this procedure. In the literature, the mortality rate associated with PMBV has been reported as 1%. The presence of intracardiac thrombus is a contraindication for PMBV. However, thrombus formation during the process is a very rare condition. In this case, we present a patient with rheumatic mitral stenosis, with both pericardial effusion and intracardiac thrombus, after laseration at the base of the left atrium during the valvuloplasty procedure.

Evaluating the effectiveness of echocardiographic guidance in diminishing postoperative wound complications for left atrial appendage closure: A clinical retrospective study

“…TEE provides detailed visualization of the LAA, facilitating accurate device placement, minimizing procedural duration and potentially reducing the risk of complications associated with device misplacement, such as pericardial effusion or device-related thrombus formation. 9,10 The hypothesis that echocardiographic guidance could also play a role in reducing surgical site complications is grounded in the premise that more precise procedural execution might lead to less tissue trauma and, consequently, more favourable wound healing outcomes. This retrospective analysis, therefore, delves into the relationship between the use of echocardiographic guidance in LAA closure procedures and the incidence of postoperative surgical site wound complications.…”

“…Echocardiographic guidance, particularly transoesophageal echocardiography (TEE), has emerged as a vital tool in LAA closure procedures. TEE provides detailed visualization of the LAA, facilitating accurate device placement, minimizing procedural duration and potentially reducing the risk of complications associated with device misplacement, such as pericardial effusion or device‐related thrombus formation 9,10 . The hypothesis that echocardiographic guidance could also play a role in reducing surgical site complications is grounded in the premise that more precise procedural execution might lead to less tissue trauma and, consequently, more favourable wound healing outcomes.…”

Thrombus formation during septal puncture

“…This issue is important in patients, particularly with atrial fibrillation (AF) due to risk of thrombus formation. We have reported a case of mitral stenosis and AF who was administered UFH after septostomy and developed thrombus right after trauma of puncture of interatrial septum during percutaneous mitral balloon valvuloplasty (PMBV) ( 2 ). We attributed the thrombus formation to the damage to interatrial septum during septostomy and no anticoagulation with UFH before septostomy in patients with AF.…”