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Reverse-Loop Technique for PTMC

Video Supplement to “Reverse-Loop Technique for Percutaneous Transvenous Mitral Commissurotomy in a Patient With Huge Left Atrium" [December 2019 Clinical Images article by Vijayvergiya, et al].

We present a 34-year-old man with chronic rheumatic heart disease, severe mitral stenosis, atrial fibrillation, and NYHA class III was was referred for percutaneous transvenous mitral commissurotomy (PTMC) after 2 failed attempts at another institute over the past 5 years; both attempts failed because the operator was unable to cross the mitral valve with the balloon. This imaging series demonstrates the reverse-loop technique, which is an alternative to conventional direct-entry technique during PTMC in patients with large left atriums.


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