TRANSSEPTAL MITRAL BALLOON VALVOTOMY IN PATIENTS WITH ATRIAL SEPTAL ANEURYSMS

Transthoracic and transoesophageal echocardiography (TTE, TEE) were pe rformed in 130 consecutive patients referred for mitral balloon valvot omy. Atrial septal aneurysms were diagnosed by TTE and TEE in 2 and 3 patients, respectively. All 3 patients underwent mitral balloon valvot omy via the transseptal route. The foramen ovale was found to be paten t in 2 of these patients, thus rendering puncture of the interatrial s eptum unnecessary. In the 3rd patient transseptal catheterisation was performed through the wall of the aneurysm itself. There were no signi ficant complications in any of these patients. No left-to-right intera trial shunting could be demonstrated by oximetry in any of the 3 patie nts. Transoesophageal colour flow imaging showed trivial shunting in 2 patients and none in the 3rd. Transseptal mitral balloon valvotomy ca n be performed safely in patients with atrial septal aneurysms, especi ally in those with co-existent patent foramen ovale.