A Case of Mitral Restenosis Complicated with Residual Atrial Septal Perforation after 8 Years on PTMC

(Department of Cardiovascular Surgery, Machida Civil Hospital, Machida, Japan)

Shingo Taguchi Yoshimasa Sakamoto
A 63-year-old woman, had been referred to our hospital on diagnoses of mitral restenosis (MS) and tricuspid regurgitation (TR) 8 years after on percutaneous transvenous mitral commissurotomy (PTMC). Echocardiography revealed an additional finding of residual atrial septal perforation (ASP). Mitral valve replacement, tricuspid valve annuloplasty and direct closure of the ASP was performed. Though ASP is major complication of PTMC, few cases of ASP remain patent for such a long time. Since the patients with MS and residual ASP after PTMC present hemodynamics such as Lutembacher syndrome, there is a possibility of biventricular failure in an early phase along with progression of secondary TR. In a patient with residual ASP after PTMC, careful observation by echocardiography is mandatory, particularly regarding occurrence of regurgitation, restenosis, or both.
@Jpn. J. Cardiovasc. Surg. 34: 291-294 (2005)