Balloon mitral valvuloplasty: Our experience with a modified technique of crossing the mitral valve in difficult cases

Manjunath, Cholenahally Nanjappa; Srinivasa, K; Patil, Chandrakanth B; Venkatesh, Huchappa V.; Bhoopal, T. S.; Dhanalakshmi, C.

doi:10.1002/(sici)1097-0304(199805)44:1<23::aid-ccd6>3.0.co;2-9

Cited by 28 publications

(16 citation statements)

References 3 publications

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“…The other indication for OTW technique is presence of left atrial thrombus (type Ia, Ib and IIa) 6. There are no major complications attributable to this technique 6 12. In the present report, OTW technique was applied in view of the highly deformed double orifice mitral valve rather than the septal bulge.…”

Section: Discussionmentioning

confidence: 80%

“…Here, the same coiled 0.025-inch guidewire, as used in the conventional technique, is steered across the mitral orifice into the LV and then the balloon is guided across the wire into the LV. There are reports of OTW technique from our own institute and other centres as well 6 12 13. In cases with critical MS and when there is abnormal bulge of the interatrial septum, the usual direct method of crossing the mitral valve may not be successful.…”

Section: Discussionmentioning

confidence: 99%

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Application of a novel percutaneous transluminal mitral commissurotomy technique in deformed mitral valve

Thomas

Ananthakrishna²,

Chikkabasavaiah³

et al. 2011

Case Reports

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A 40-year-old woman, known to suffer from rheumatic heart disease, presented with New York Heart Association class III breathlessness of 6 months duration. Transthoracic echocardiogram revealed severe mitral stenosis with deformed double orifice-like mitral valve and severe interatrial septal bulge. Considering the unfavourable anatomy, a high-risk percutaneous transluminal mitral commissurotomy (PTMC) was planned. Initial septal puncture resulted in pericardial effusion with tamponade, which was effectively managed by pericardiocentesis. After haemodynamic stabilisation and a fresh septal puncture, repeated efforts were made to negotiate the balloon across the deformed valve using the conventional Inoue technique. As the attempts were unsuccessful, the authors planned for over-the-wire (OTW) technique, with which the procedure was accomplished successfully. A technically challenging case of PTMC in the presence of adverse factors is presented herein. OTW technique is a useful alternative in the presence of deformed mitral valve.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Application of a novel percutaneous transluminal mitral commissurotomy technique in deformed mitral valve

Thomas

Ananthakrishna²,

Chikkabasavaiah³

et al. 2011

Case Reports

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“…We can classify1 the thrombus in the left atrium as Ia (thrombus confined to LAA), Ib (thrombus in LAA and protruding into LA cavity), IIa (attached to LA roof but above the plane of fossa ovalis), IIb (reaching below plane of fossa ovalis), III (attached to interatrial septum), IV (mobile with attachment to roof or lateral wall) and V (ball valve thrombus). Types Ia, Ib and IIa can undergo BMV by using modified over the wire technique 2. Traditionally, LA thrombus was a contraindication for BMV but it can be carried out in the above scenarios of thrombus with almost 100% success in the hands of experienced operators.…”

Section: Descriptionmentioning

confidence: 99%

Spectrum of left atrial thrombus in rheumatic heart disease

Mahla

Harlalka

Bhairappa³

et al. 2014

BMJ Case Reports

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“…The echolucent centre suggests that the thrombus is relatively new and is actively growing 2. This has practical importance for patient management as PTMC can be performed safely in presence of organised LA clot (types Ia, Ib and IIa) 3. PTMC should be deferred till the clot resolves or get organised.…”

Section: Descriptionmentioning

confidence: 99%