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The scheduled balloon mitral valvotomy via trans\u2010femoral approach was abandoned after the venogram revealed the presence of left\u2010sided inferior vena cava with hemi\u2010azygos continuation draining into coronary sinus via left\u2010sided superior vena cava. Balloon mitral valvotomy was attempted from the right trans\u2010jugular route, but we were unable to puncture the inter\u2010atrial septum due to the hugely dilated coronary sinus and right atrium. A transhepatic approach was used and balloon mitral valvotomy was successfully done with a standard balloon of 24\u2009mm size without any complication. In patients with inferior vena cava anomalies or interruption, a percutaneous transhepatic approach is a feasible alternative for performing balloon mitral valvotomy.<\/jats:p>","DOI":"10.1002\/ccd.30240","type":"journal-article","created":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T07:55:17Z","timestamp":1653897317000},"page":"256-260","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Transhepatic balloon mitral valvotomy in mitral stenosis with interrupted inferior vena cava"],"prefix":"10.1002","volume":"100","author":[{"given":"Vijay","family":"Trehan","sequence":"first","affiliation":[{"name":"Department of Cardiology G.B. Pant Institute of Post Graduate Medical Education and Research  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"family":"Safal","sequence":"additional","affiliation":[{"name":"Department of Cardiology G.B. 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