{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:13:27Z","timestamp":1753877607206,"version":"3.41.2"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2020,8,10]],"date-time":"2020-08-10T00:00:00Z","timestamp":1597017600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Percutaneous transvenous mitral valvuloplasty (PTMV) is an established therapy for rheumatic mitral stenosis (MS). While the Wilkins score standardizes the description of valve anatomy and predicts successful PTMV, echocardiographic assessment has some limitations. The \u2018balloon impasse\u2019 sign is the inability to cross a stenotic valve with a deflated Inoue balloon. This sign was described in the 1990s as an indicator of severe subvalvular thickening (regardless of the echocardiographic findings), portending an increased risk of severe mitral regurgitation (MR) post-PTMV. Despite its implications for management, it has been seldom reported. A 57-year-old woman with symptomatic, severe MS and a Wilkins score of 7 underwent PTMV. The \u2018balloon impasse\u2019 sign was observed when attempting to cross the stenotic valve. When the balloon was fully inflated, severe MR was noted, and the patient required mitral valve replacement. This case demonstrates the continued importance of the \u2018balloon impasse\u2019 sign and its implications for the therapeutic efficacy of PTMV.<\/jats:p>","DOI":"10.1093\/omcr\/omaa062","type":"journal-article","created":{"date-parts":[[2020,8,10]],"date-time":"2020-08-10T18:47:07Z","timestamp":1597085227000},"source":"Crossref","is-referenced-by-count":1,"title":["The balloon impasse sign in percutaneous transvenous mitral valvuloplasty"],"prefix":"10.1093","volume":"2020","author":[{"given":"Trevor","family":"Simard","sequence":"first","affiliation":[{"name":"CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada"},{"name":"Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tharshika","family":"Thangarasa","sequence":"additional","affiliation":[{"name":"Faculty of Undergraduate Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Di Santo","sequence":"additional","affiliation":[{"name":"CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alisha","family":"Labinaz","sequence":"additional","affiliation":[{"name":"CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Hibbert","sequence":"additional","affiliation":[{"name":"CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada"},{"name":"Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,8,10]]},"reference":[{"key":"2020082807120476200_ref1","doi-asserted-by":"crossref","first-page":"e57","DOI":"10.1016\/j.jacc.2014.02.536","article-title":"AHA\/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"63","author":"Nishimura","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"2020082807120476200_ref2","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1136\/hrt.60.4.299","article-title":"Percutaneous balloon dilatation of the mitral valve: an analysis of echocardiographic variables related to outcome and the mechanism of dilatation","volume":"60","author":"Wilkins","year":"1988","journal-title":"Br Heart 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