Successful percutaneous removal of broken mitral valvuloplasty coiled tip guidewire
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CASE REPORT
Successful percutaneous removal of broken mitral valvuloplasty coiled tip guidewire Shivananda Patil • Ashish Agarwal • Rangaraj Ramalingam • Tarun Kumar • Neena Agarwal • Cholenahally N. Manjunath
Received: 17 December 2012 / Accepted: 31 March 2013 Ó Japanese Association of Cardiovascular Intervention and Therapeutics 2013
Abstract Complications related to hardware malfunction during balloon mitral valvuloplasty (BMV) are rarely met in catheterization laboratory. However, the consequences can be grave including death. We report an extremely rare complication of fracture of BMV coiled tip guidewire, which was successfully retrieved percutaneously with a relatively simple technique. Finally the procedure was completed without any complication.
potentially fatal complications. These complications are relatively more common in reused hardware, which is a difficult to avoid situation in countries with financial constraints. In this report, we have described a case of successful percutaneous retrieval of fractured BMV coiled tip guidewire with no eventual complication.
Case report Introduction Percutaneous balloon mitral valvuloplasty (BMV) is a safe and effective therapy for mitral stenosis (MS) and has comparable success and re-stenosis rates with surgical mitral commissurotomy. Nowadays, BMV is the treatment of choice for significant symptomatic MS provided valve morphology is suitable and contraindications are absent. Complications are acute mitral regurgitation, embolic events, cardiac tamponade, infection, vascular access complications and rarely death. Hardware malfunction, dislodgement and embolization, though relatively rare, are
Electronic supplementary material The online version of this article (doi:10.1007/s12928-013-0178-8) contains supplementary material, which is available to authorized users. S. Patil A. Agarwal (&) R. Ramalingam T. Kumar C. N. Manjunath Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Jayanagar 9th Block, BG Road, Bangalore 560069, India e-mail: [email protected]; [email protected] N. Agarwal Department of Emergency Medicine, Kempe Gowda Institute of Medical Sciences, Bangalore, India
A 50-year-old female presented with history of New York Heart Association (NYHA) class III dyspnea of 1 year duration. Transthoracic echocardiogram showed severe rheumatic MS with a valve area of 0.8 cm2. Wilkins score was six. There was no significant mitral regurgitation and transesophageal echocardiogram showed no left atrial or atrial appendage clot. Because the valve was suitable for BMV, elective procedure was planned using the standard Inoue technique [1]. However, we used Accura balloon catheter (Vascular Concepts, Essex, UK) in the place of Inoue balloon catheter (Toray Industries, Japan). As described by Manjunath et al. [2], both balloons are comparable in terms of efficacy and safety, but the Accura balloon is significantly less costly. Both the Accura and Inoue balloon catheters are manufactured from polyvinyl chlor
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