PENETRATION OF THE INTERATRIAL SEPTUM - A RARE COMPLICATION OF PERCUTANEOUS TRANSLUMINAL MITRAL COMMISSUROTOMY

Interatrial septal dissection and penetration into the aorta by a ball oon catheter occurred in a 38-year-old man with mitral stenosis as a c omplication of percutaneous transluminal mitral commissurotomy during trans-septal puncture. It was speculated that the thickened septum was partially punctured into the potential space between the septa primum and secundum. Then, the balloon catheter went through the interatrial septum dissection into the aortic root. Emergency surgery was perform ed with the catheter left in situ. The surgical findings confirmed the speculated mechanism of this rare complication. In order to avoid thi s complication, the location of the tip of the Brockenbrough catheter after transseptal puncture must be confirmed. Checking the left atrial pressure tracing, arterial oxygenation and contrast injection are all important and indispensable procedures.