Safety of percutaneous transvenous balloon mitral commissurotomy in patients with mitral stenosis and thrombus in the left atrial appendage

Percutaneous transvenous mitral commissurotomy (PTMC) is an effective therapeutic alternative for patients with symptomatic mitral stenosis (MS).1-4 Left atrial thrombus occurs frequently in MS and is generally considered as a contraindication to PTMC.1-4 Since the introduction of transesophageal echocardiography, even a small thrombus confined to the left atrial appendage can be detected.5,6 Whether such patients should be denied the potential benefits of PTMC and be subjected to mitral valve surgery is an issue of clinical interest. To our knowledge, there have been few studies of PTMC in patients with MS and left atrial thrombus.6,7 This study reports on the safety and efficacy of PTMC in patients with MS and left atrial appendage thrombus. © 1992.