Percutaneous Transcatheter Balloon Mitral Commissurotomy

Abstract

Rheumatic mitral stenosis remains the most common acquired heart disease in developing countries needing intervention. Percutaneous transcatheter mitral commissurotomy (PTMC) by the Inoue method has emerged as the most practical, safe, and effective means of relieving mitral stenosis in patients with favorable characteristics. In selected patients and when performed by experienced operators, PTMC produces excellent early and long-term clinical results with a low procedural risk. Increasing age, previous commissurotomy, mitral valve morphology score of >8, valve calcification, and associated mitral regurgitation are predictors of suboptimal result. Possible complications of PTMC are worsening of mitral regurgitation, cardiac perforation, systemic embolism, and failed procedure. These can be minimized by proper selection of case, meticulous technique, and operator experience.