title: Cardio-embolic stroke due to valve tissue embolization during percutaneous transseptal mitral commissurotomy (PTMC).
abstract: Percutaneous transseptal mitral commissurotomy (PTMC) has replaced surgical commissurotomy as a treatment of choice in selected patients of rheumatic mitral stenosis. Various randomized trials have shown PTMC to be equal or superior to surgical commissurotomy in terms of hemodynamic improvement as well as long term survival. Systemic embolism is one of the dreaded complications of PTMC, which is reported in 0.5-5% of cases and involves cerebral circulation in 1% of cases. Most of the time, periprocedural embolism during PTMC is caused by the mobilization of preexisting thrombus in the left atrial appendage. We report an unusual case of acute stroke due embolization of mitral valve tissue during PTMC.
authors.affiliation: Department of Cardiology, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Sudhir S
authors.initials: SS
authors.lastname: Shetkar
authors.affiliation: Assistant Professor, Department of Cardiology, All India Institute of Medical Sciences, New Delhi 110029, India. Electronic address: neerajparakh@yahoo.com.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Parakh
authors.affiliation: Department of Cardiology, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Birdevender
authors.initials: B
authors.lastname: Singh
authors.affiliation: Department of Neuroradiology, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: N K
authors.initials: NK
authors.lastname: Mishra
authors.affiliation: Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Ruma
authors.initials: R
authors.lastname: Ray
authors.affiliation: Department of Cardiology, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Ganesan
authors.initials: G
authors.lastname: Karthikeyan
authors.affiliation: Department of Cardiology, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Yadav
authors.affiliation: Department of Cardiology, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Kewal C
authors.initials: KC
authors.lastname: Goswami
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods*; D004452:Echocardiography; D004617:Embolism / Q000209:etiology*; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed
keywords: Embolization; Mitral stenosis; Stroke; Valve tissue