Apollo Hospital, India
Posters & Accepted Abstracts: J Clin Exp Cardiolog
Rheumatic Heart Disease (RHD) is a major health hazard in most developing countries as well as sporadically in developed economies with high prevalence rates. Mitral stenosis is among the important morbid valvular conditions accounting for 25% of RHD cases. Percutaneous Transmitral Commissurotomy (PTMC) using Inoue Balloon is the standard treatment for severe mitral stenosis with favorable Wilkins score. In certain cases, it is difficult to cross Mitral Valve (MV) either due to dilated Left Atrium (LA), low septal puncture or severe mitral valvular and sub-valvular stenosis leading to prolonged procedure time or failure of PTMC procedure. Techniques like reverse loop, double loop, over the wire double-balloon, multitrack system with two balloons being simultaneously inflated in proper position, Swan-Ganz catheter facilitating LV entry have been described in literature with their own merits and demerits. We describe a case of RHD with severe mitral stenosis and dilated LA where crossing MV was difficult and successful PTMC was performed using rapid snare sliding technique to cross the MV. A rapid snare sliding technique was found to be quick, safe and a good alternative with good results and few complications. We describe the interventional steps of this technique in this case report.