Percutaneous Transvenous Mitral Commissurotomy in a Postoperative Patient With the Pericardial Patch Repair of an Atrial Septal Defect

Document Type : Case Report


Department of Cardiology , Advanced Cardiac Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India.


Coexistence of an atrial septal defect (ASD) and acquired rheumatic mitral valve disease is uncommon. Transseptal puncture during percutaneous transvenous mitral commissurotomy (PTMC) can be technically difficult and challenging in patients with the pericardial or synthetic patch at the interatrial septum following ASD repair. We describe a middle-aged woman who had pericardial patch repair of ASD during childhood and now presented with severe, symptomatic rheumatic mitral stenosis. She had successful PTMC through a transseptal approach, following the puncture of the pericardial patch. The technical details about the transseptal approach following the surgical patch repair of the ASD are discussed in the article. (Iranian Heart Journal 2022; 23(2): 116-119)


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