Publication

Abstract : This chapter describes emergency surgery after percutaneous mitral valvotomy. Inoue and colleagues in 1984 described percutaneous transmitral commissurotomy as an effective alternative to closed mitral valvuloplasty (CMV) for mitral stenosis (MS). Reported complications of percutaneous mitral valvotomy (PMV) include mitral regurgitation (MR), cardiac tamponade, complete heart block, thromboembolism, and left-to-right shunt across the septal puncture. Emergency surgery is rarely needed for the complications resulting from PMV. It may be required, however, for massive hemopericardium resulting from left ventricular or atrial perforation unresponsive to pericardiocentesis or, for severe MR leading to hemodynamic collapse or refractory pulmonary edema. This chapter covers the incidence, hemopericardium and cardiac tamponade, mechanism of hemopericardium, management of hemopericardium and cardiac tamponade, acute mitral regurgitation, mechanism of mitral insufficiency, and management of mitral insufficiency.