ABSTRACT
In June 1982, the first clinical application of transvenous mitral commissurotomy was performed successfully by Inoue et al. by using a handmade Inoue balloon catheter. The Inoue balloon catheter has a single balloon that is made of a double layer of latex rubber, with a synthetic micromesh inserted between the layers for reinforcement. The presence of left atrial thrombus is a general contraindication for PTMC. If the thrombi are immobile, such patients should be treated with warfarin for at least 6 weeks. Percutaneous transvenous mitral commissurotomy (PTMC) can then be applied safely after the thrombi have resolved. Other valvular diseases do not hamper the procedure. In patients with aortic regurgitation, the occurrence of congestive heart failure due to acute volume loading of the left ventricle following PTMC might theoretically be a problem. Patients in atrial fibrillation or those with a history of paroxysmal atrial fibrillation should be anticoagulated with warfarin for at least 6 weeks.
