Chasing Complications of Balloon Mitral Valvotomy.

Percutaneous balloon mitral valvotomy (BMV) done for mitral stenosis (MS) though largely improved nowadays can be followed by multiple and rare procedure related complications. We present an interesting case of a 45 year old male with symptomatic severe mitral stenosis of rheumatic origin. Ultimately, though he underwent a successful BMV it was ridden with multiple rare procedure related complications. Intra procedural perforation of left atrium with hemopericardium and pericardial tamponade occurred in the first attempt at BMV while rupture of BMV balloon, multiple clots in left atrium (LA) after the procedure and a large pericardial effusion occurred in the second albeit successful attempt. To the best of our knowledge this is the first case to report multiple LA clots post BMV.

Left atrial ball thrombus with acute mesenteric ischemia: Anesthetic management and role of transesophageal echocardiography.

A 62 year old female with severe mitral stenosis, large left atrial ball thrombus and acute mesenteric ischemia emergently underwent mitral valve replacement, left atrial clot removal and emergency laparotomy for mesenteric ischemia. Peri‑operative management issues, particularly, the anesthetic challenges and the role of transesophageal echocardiography are discussed.