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After percutaneous transvenous mitral commisurotomy, the patient was expected to have a patent atrial septal defect, which would be easily crossed. However, on TEE, the left atrium was noted to be very dilated and widening to the right.It was anticipated that puncture would be difficult if sliding along the bulge.
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After percutaneous transvenous mitral commisurotomy, the patient was expected to have a patent atrial septal defect, which would be easily crossed.
Authors
Singh Harsimran1, Panchanatham Manokar1, Senguttuvan Nagendra Boopathy1, Ramesh Sankaran1, Sadhanandham Shanmugam1, Muralidharan Thoddi Ramamurthy1, Balakrishnan Vinod Kumar1, Periyasamy Santhosh Kumar1
- Sri Ramachandra Institute of Higher Education and Research, Tamil Nadu, India
1 comment
In large LA, posterior puncture can lead to stitch phenomenon(RA-LA puncture and bypassing the septum) . In that case, patient is having pericardial tamponade either after removal of dilator or after removal of the balloon. The management is to keep the dilator or balloon inside the defect, followed by the surgical closure of the defect.