Left ventricular perforation during percutaneous balloon mitral valvuloplasty

Percutaneous balloon mitral valvuloplasty has been reported to be complicated by left ventricular perforation with fatal results. We report two cases of left ventricular perforation following balloon mitral valvuloplasty. In one patient left ventricular perforation occurred silently without any hemodynamic sequelae and was only detected at left ventricular angiography after valvuloplasty. In the second patient left ventricular perforation was caused by the mitral dilating balloon catheter. The subsequent tamponade was relieved by immediate aspiration with hemodynamic stabilization thereafter. Neither patient required surgery. Both patients are well 6 mon after the procedure. We discuss the mechanism of this serious complication in these two patients.