Novel Wire-Based Technique for Percutaneous Balloon Mitral Valvuloplasty
Related Experiment Video
Updated: Jun 23, 2026
A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Tanush Gupta1, Trace Barrett1, Harold L Dauerman1
1Division of Cardiology, University of Vermont Medical Center, Burlington, Vermont, USA.
Objectives:
Percutaneous balloon mitral valvuloplasty (PBMV) for rheumatic mitral stenosis (MS) using the classical Inoue technique can be technically challenging, especially in difficult anatomies. This paper describes a novel wire-based technique of PBMV that involves advancement of the Inoue balloon over a preshaped stiff 0.035-inch wire.
Key Steps:
These include targeted transseptal puncture, advancement of a steerable sheath to the left atrium, crossing the diseased mitral valve, exchanging for a 0.035-inch preshaped wire in the left ventricle, slenderization of the appropriately sized Inoue balloon on the wire, advancement and positioning of the balloon across the mitral valve, and balloon inflation.
Potential Pitfalls:
This technique does use additional equipment, in addition to that in the standard Inoue balloon kit, specifically a steerable sheath and an 0.035-inch preshaped stiff wire.
Take-Home Messages:
Due to lower prevalence of rheumatic mitral stenosis in higher-income countries, even high-volume structural operators gain lesser experience with PBMV procedures. PBMV can be performed in a safe, predictable manner over the wire using the described approach.
