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Retrograde Balloon Mitral Valvotomy for Severe Mitral Stenosis With Interrupted Inferior Vena Cava Complicating
Ramesh Ramachandran1, Sathish Kumar Subburaj1, Selvarani Gnanamuthu1
1Department of Cardiology, Government Rajaji Hospital and Madurai Medical College, Madurai, India.
Background:
Rheumatic mitral stenosis complicating pregnancy is a common clinical scenario encountered in cardio-obstetrics clinics in India. The condition needs a heart team approach for successful fetal and maternal outcomes.
Case Summary:
A 26-year-old woman, at 28 weeks of gestation, with an interrupted inferior vena cava presented with severe mitral stenosis. Transarterial retrograde balloon mitral valvotomy was performed using a 25 × 40 mm Tyshak balloon catheter because of the inability to do it transvenously.
Discussion:
Anatomic variability in the form of an interrupted inferior vena cava and inability to perform transseptal puncture through the right internal jugular vein prompted the heart team to successfully perform transarterial retrograde ballon mitral valvotomy in this pregnant patient.
Take-Home Message:
An alternate plan of management should always be prepared when a complex interventional procedure is being planned in a pregnant patient with a variant anatomy.
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