Heart 1998;79:200-202 ( February )
Case report
Traumatic damage to the mitral valve during percutaneous balloon
valvotomy for critical aortic stenosis
Department of Paediatric
Cardiology, Royal Brompton National Heart and Lung Hospital,
Sydney Street, London SW3 6NP,
UK
Correspondence to: Professor Redington.
Accepted for publication 6 October 1997
Percutaneous balloon valvuloplasty is now a widely accepted
alternative to surgical valvotomy for patients with congenital aortic
valve stenosis. Mitral valve anomalies are well known to coexist and
influence the prognosis from all palliative procedures. Two cases of
mitral valve injury occurring during balloon aortic valvuloplasty are
reported, one an 11 month old boy, the other a 2 day old baby boy. Both
cases were characterised by an unusually posterior position of the
guidewire, over which the balloon was deployed. The wire, and hence the
balloon, may have been placed through the tension apparatus of the
mitral valve with subsequent damage to its free edge on inflation. This
is at least conceptually more likely to occur if the orifice of the
valve is posterior, if there is a small left ventricular cavity, or if
the mitral valve itself is abnormal
features present in both cases.
Possible strategies for decreasing the incidence of such damage are considered.
© 1998 by Heart
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