Penetration of the interatrial septum: a rare complication of percutaneous transluminal mitral commissurotomy.
Interatrial septal dissection and penetration into the aorta by a balloon catheter occurred in a 38-year-old man with mitral stenosis as a complication 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 performed with the catheter left in situ. The surgical findings confirmed the speculated mechanism of this rare complication. In order to avoid this complication, the location of the tip of the Brockenbrough catheter after transeptal puncture must be confirmed. Checking the left atrial pressure tracing, arterial oxygenation and contrast injection are all important and indispensable procedures.
Tseng
C D
CD
Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, ROC.
Hsu
K L
KL
Tseng
Y Z
YZ
Chiang
F T
FT
Hwang
J J
JJ
Lin
F Y
FY
D000328:Adult; D001011:Aorta / Q000000981:diagnostic imaging / Q000293:injuries*; D002404:Catheterization / Q000009:adverse effects*; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000293:injuries*; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000628:therapy*; D014463:Ultrasonography