Percutaneous Mitral Balloon Valvulotomy in Patients With Thrombus in Left Atrial Appendage

Percutaneous mitral balloon valvulotomy (PMV) is an effective and safe alternative to surgery in patients with syptomatic mitral stenosis. Thrombus formatian in left atrial appendage (LAA) is a comman finding. We report about the results of TEE-guided valvulotomy in 14 cases with LAA thrombus. All patients were anticoagulated for one month. TEE prior to valvulotomy showed no thrombus in 5 (36%) patients. Nine paticnts underwent multiplane TEE-guided valvulotomy . Eight of them (88%) were female. Mean age was 39.7±8.6 years . All were in atrial fibrillation. Valve area, mean mitral gradient and systolic pulmonary artery pressures pre- and postoperative were 0.97±0.22 cm² vs 1.94±0.27 cm² (p <0.01) , 13.7± 3.76 mmHg vs 3.57±1.9 mmHg (p<0.01) and 69.4±18.1 mmHg vs 36±10 mmHg (p<0.0.1), respectively. None of the cases showed an embolic phenomenon or other complication.