Mitral valvuloplasty complicated by catheter perforation of the right atrium and the aortic root

Abstract

According with latest guidelines, percutaneous mitral commissurotomy (PMC) represents the first-line treatment for symptomatic severe mitral valve stenosis (SMVS) with favourable morphology, We report a successful surgical treatment of a potential life-threatening complication occurred during PMC. Heart-Team discussion and closed collaboration with Centres are crucial for decision-making and Cardiac Surgery onsite should be ensured for high-risk procedures. Case report A 77-year-old female with symptomatic SMVS was admitted to a secondary referring Hospital. Transoesophageal echocardiography demonstrated a SMVS (valve area 0,9-1 cm 2 and mean gradient of 17 mmHg), with commissural fusion, diffused calcification of the annulus and leaflets, and no mitral regurgitation. LVEF was 60% and there were no left atrial thrombi. Severe pulmonary hypertension (PAPs 85 mmHg) was identified.