Angiographic recognition of a proximal balloon tear during Inoue balloon mitral valvotomy

Accura balloon rupture during percutaneous trans-septal mitral commissurotomy: a rare and potentially fatal complication

Percutaneous transseptal mitral commissurotomy (PTMC) is the treatment of choice in rheumatic mitral stenosis. The reuse of sterilised PTMC balloon catheters is widely practised to bring down the procedure cost and have proven safety and efficacy. The reused balloons may deform and are prone to rupture causing fatal complications like embolism either of the torn balloon material or air. We report a first case of Accura balloon rupture during PTMC to the best of our knowledge. Fortunately, there was no complication in our patient. Thus, during the balloon preparation it should be examined for any deformity or tear and air should be removed completely to prevent fatal outcome. The repeated use of the hardware should be limited and an informed consent regarding the possible complications of the reused hardware should be taken.

Inoue balloon deformity and rupture during percutaneous balloon valvuloplasty

In the management of mitral stenosis, similar long-term results can be obtained by using either an Inoue balloon catheter or a double-balloon technique for percutaneous balloon valvuloplasty. There have been few reports concerning any deformity of an Inoue balloon. From January 1988 to June 1995, 263 procedures of either mitral or tricuspid valvuloplasty have been performed in this center. The Inoue balloon catheter technique was used for 245 procedures. A deformity of the Inoue balloon catheter was noted in 4 (1.6%) and actual rupture of deformed balloon occurred in one (0.4%). All deformities were found at the distal portion of the Inoue balloon. Valvular insufficiency became more severe after valvuloplasty in two cases. Following rupture of the balloon, neither arterial embolization nor perforation of the cardiac chambers developed. In conclusion, a deformity of the Inoue balloon, although rare, can develop during percutaneous balloon valvuloplasty. The deformity may portend balloon rupture if additional maximal dilatations are undertaken.

Inoue balloon rupture during dilatation of calcified mitral valves

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