title: Transjugular balloon mitral valvotomy in a patient with severe kyphoscoliosis.
abstract: Balloon mitral valvotomy (BMV) performed by the conventional transfemoral approach can be difficult or even impossible in the presence of structural impediments such as severe kyphoscoliosis, gross cardiac anatomic distortion and inferior vena caval anomalies. A 25-year-old woman with severe thoracolumbar kyphoscoliosis due to poliomyelitis presented with symptomatic rheumatic mitral valve stenosis. After the failure of transfemoral BMV, the procedure was attempted from the right jugular access, using a modified septal puncture technique. The left atrium was entered from the jugular access and the mitral valve was crossed and dilated successfully using over the wire balloon technique. Transjugular BMV is an effective alternative in patients with kyphoscoliotic spine that preclude transfemoral approach. The detailed technique used for the procedure, its advantages as well as the other percutaneous treatment options are also discussed.
authors.affiliation: Department of Cardiology, Christian Medical College, Vellore, India.
authors.forename: George
authors.initials: G
authors.lastname: Joseph
authors.affiliation: Department of Cardiology, Christian Medical College, Vellore, India. Electronic address: drmithunjv@gmail.com.
authors.forename: Mithun J
authors.initials: MJ
authors.lastname: Varghese
authors.affiliation: Department of Cardiology, Christian Medical College, Vellore, India.
authors.forename: Oommen K
authors.initials: OK
authors.lastname: George
mesh_terms: D000328:Adult; D063126:Balloon Valvuloplasty / Q000379:methods*; D002405:Catheterization, Central Venous / Q000379:methods*; D004452:Echocardiography; D005260:Female; D006801:Humans; D007601:Jugular Veins; D007738:Kyphosis / Q000150:complications* / Q000175:diagnosis; D008946:Mitral Valve Stenosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D013902:Radiography, Thoracic; D012214:Rheumatic Heart Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D012600:Scoliosis / Q000150:complications* / Q000175:diagnosis; D012720:Severity of Illness Index
keywords: BMV; Jugular veins; Mitral stenosis; Mitral valvuloplasty; Scoliosis