LEFT-VENTRICULAR PERFORATION DURING PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY WITH EMERGENCY-SURGERY

Two cases of left ventricular (LV) perforation by balloon catheter fol lowing successful balloon mitral valvuloplasty are presented. The firs t patient was dilated first with a single straight-tip balloon cathete r and after with a doubt balloon catheter. The second patient underwen t a valvuloplasty with a double balloon catheter only. The subsequent tamponade was treated by immediate aspiration but without hemodynamic improvement. Both patients required emergency surgery with surgical re pair of the LV apex, and both of them could be weaned. Both patients a re well 18 months after the procedure. We discuss the mechanism of thi s serious complication and technical considerations to prevent it.