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MCQ 18: Brockenbrough needle (25)

Q. Brockenbrough needle is used for?
A. Tricuspid valve commissurotomy
B. Interatrial septal puncture
C. Interventricular septal puncture
D. Pulmonary valvotomy


Answer: B. Interatrial septal puncture

Explanation:
Percutaneous mitral valve commissurotomy (PTMC) is required in severe symptomatic noncalcific mitral stenosis. It should be done after ruling out LA/LAA thrombus.
For PTMC, right atrium is entered through IVC from right remoral venous access. To reach the left atrium from right atrium, interatrial septum has to punctured at fossa ovalis which is done with the help of Brockenbrough needle. After that Inoue balloon is inflated at level of mitral valve to improve mitral stenosis. 
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