{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:03:40Z","timestamp":1756339420515,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>A 40-year-old woman, known to suffer from rheumatic heart disease, presented with New York Heart Association class III breathlessness of 6 months duration. Transthoracic echocardiogram revealed severe mitral stenosis with deformed double orifice\u2013like mitral valve and severe interatrial septal bulge. Considering the unfavourable anatomy, a high-risk percutaneous transluminal mitral commissurotomy (PTMC) was planned. Initial septal puncture resulted in pericardial effusion with tamponade, which was effectively managed by pericardiocentesis. After haemodynamic stabilisation and a fresh septal puncture, repeated efforts were made to negotiate the balloon across the deformed valve using the conventional Inoue technique. As the attempts were unsuccessful, the authors planned for over-the-wire (OTW) technique, with which the procedure was accomplished successfully. A technically challenging case of PTMC in the presence of adverse factors is presented herein. OTW technique is a useful alternative in the presence of deformed mitral valve.<\/jats:p>","DOI":"10.1136\/bcr.04.2011.4116","type":"journal-article","created":{"date-parts":[[2011,6,22]],"date-time":"2011-06-22T09:42:58Z","timestamp":1308735778000},"page":"bcr0420114116","source":"Crossref","is-referenced-by-count":1,"title":["Application of a novel percutaneous transluminal mitral commissurotomy technique in deformed mitral valve"],"prefix":"10.1136","volume":"2011","author":[{"given":"Tony","family":"Thomas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajiv","family":"Ananthakrishna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nagamani Alur","family":"Chikkabasavaiah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramesh","family":"Basavappa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2011,6,22]]},"reference":[{"key":"2025082702454450000_2011.jun21_1.bcr0420114116.1","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/S0022-5223(19)37390-8","article-title":"Clinical application of transvenous mitral commissurotomy by a new balloon catheter.","volume":"87","author":"Inoue","year":"1984","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2025082702454450000_2011.jun21_1.bcr0420114116.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03510140091035"},{"key":"2025082702454450000_2011.jun21_1.bcr0420114116.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198512123132405"},{"key":"2025082702454450000_2011.jun21_1.bcr0420114116.4","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.1810280206"},{"key":"2025082702454450000_2011.jun21_1.bcr0420114116.5","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.190748"},{"key":"2025082702454450000_2011.jun21_1.bcr0420114116.6","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.22176"},{"key":"2025082702454450000_2011.jun21_1.bcr0420114116.7","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90680-Y"},{"key":"2025082702454450000_2011.jun21_1.bcr0420114116.8","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.60.4.299"},{"key":"2025082702454450000_2011.jun21_1.bcr0420114116.9","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.94.9.2124"},{"key":"2025082702454450000_2011.jun21_1.bcr0420114116.10","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.85.6.2014"},{"key":"2025082702454450000_2011.jun21_1.bcr0420114116.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jccase.2010.08.002"},{"key":"2025082702454450000_2011.jun21_1.bcr0420114116.12","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0304(199805)44:1<23::AID-CCD6>3.0.CO;2-9"},{"key":"2025082702454450000_2011.jun21_1.bcr0420114116.13","first-page":"796","article-title":"Percutaneous transluminal mitral commissurotomy\u2013experience with inoue balloon and over the wire technique.","volume":"50","author":"Thirumalai","year":"2002","journal-title":"J Assoc Physicians India"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr.04.2011.4116","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T09:45:53Z","timestamp":1756287953000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr.04.2011.4116"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,6,22]]},"references-count":13,"alternative-id":["10.1136\/bcr.04.2011.4116"],"URL":"https:\/\/doi.org\/10.1136\/bcr.04.2011.4116","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2011,6,22]]}}}