{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T18:16:57Z","timestamp":1783361817413,"version":"3.54.6"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Percutaneous transcatheter mitral commissurotomy (PTMC) by the Inoue technique is the traditional technique to relieve rheumatic mitral stenosis. Mucopolysaccharidoses, a group of rare lysosomal storage disorders, result in skeletal and vertebral anomalies and cardiac valvular abnormalities. The coexistence of both pathologies is rare, and mitral stenosis in such a scenario may pose significant technical challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>We present the case of a short statured 15-year-old girl with mucopolysaccharidosis Type VI with severe mitral stenosis and moderate aortic stenosis. Echocardiography revealed features suggestive of rheumatic involvement rather than due to the syndrome. Due to high surgical risk and unique anatomical characteristics, percutaneous approach was more amenable than surgery. The patient underwent successful PTMC using an unconventional over-the-wire technique instead of the traditional Inoue technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case highlights the importance of a case-based approach in unique anatomic and high-risk situations for better outcomes, which may need out-of-the-box thinking.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag266","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T17:42:23Z","timestamp":1783359743000},"source":"Crossref","is-referenced-by-count":0,"title":["Rare and rarer: percutaneous transcatheter mitral commissurotomy using over-the-wire technique in a patient with mucopolysaccharidosis\u2014a case report"],"prefix":"10.1093","volume":"10","author":[{"given":"Darshita","family":"Gosai","sequence":"first","affiliation":[{"name":"Department of Cardiology, LTMG Hospital , Mumbai 400022 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8140-4669","authenticated-orcid":false,"given":"Sriram","family":"Easwaran","sequence":"additional","affiliation":[{"name":"Department of Cardiology, LTMG Hospital , Mumbai 400022 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajaykumar","family":"Mahajan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Seth G S Medical College and KEM Hospital , Mumbai 400012 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratap","family":"Nathani","sequence":"additional","affiliation":[{"name":"Department of Cardiology, LTMG Hospital , Mumbai 400022 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milind","family":"Phadke","sequence":"additional","affiliation":[{"name":"Department of Cardiology, LTMG Hospital , Mumbai 400022 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"2026070613421642300_ytag266-B1","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1093\/eurheartj\/12.suppl_B.99","article-title":"Percutaneous transvenous mitral commissurotomy using the Inoue balloon","volume":"12","author":"Inoue","year":"1991","journal-title":"Eur Heart J"},{"key":"2026070613421642300_ytag266-B2","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1007\/s10545-011-9359-8","article-title":"Cardiac disease in patients with mucopolysaccharidosis: Presentation, diagnosis and management","volume":"34","author":"Braunlin","year":"2011","journal-title":"J Inherit Metab Dis"},{"key":"2026070613421642300_ytag266-B3","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1007\/s004310050872","article-title":"Cardiovascular changes in children with mucopolysaccharide storage diseases and related disorders\u2014clinical and echocardiographic findings in 64 patients","volume":"157","author":"Dangel","year":"1998","journal-title":"Eur J Pediatr"},{"key":"2026070613421642300_ytag266-B4","doi-asserted-by":"crossref","first-page":"1891","DOI":"10.1016\/j.jaccas.2021.10.013","article-title":"Mucopolysaccharidosis type I diagnosed by aortic and mitral valve replacement","volume":"3","author":"Sherwood","year":"2021","journal-title":"JACC Case Rep"},{"key":"2026070613421642300_ytag266-B5","first-page":"316","article-title":"Modified Inoue technique for difficult mitral balloon commissurotomy","volume":"26","author":"Meier","year":"1992","journal-title":"Cathet Cardiovasc Diagn"},{"key":"2026070613421642300_ytag266-B6","first-page":"158","article-title":"Difficult percutaneous transvenous mitral commissurotomy: a new technique for left atrium to left ventricular entry","volume":"56","author":"Trehan","year":"2004","journal-title":"Indian Heart J"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/7\/ytag266\/68703020\/ytag266.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/7\/ytag266\/68703020\/ytag266.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T17:42:24Z","timestamp":1783359744000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytag266\/8725559"}},"subtitle":[],"editor":[{"given":"Gavin","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"A Shaheer","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Mara","family":"Gavazzoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Deepti","family":"Ranganathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":6,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytag266","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7]]},"published":{"date-parts":[[2026,7]]},"article-number":"ytag266"}}