Learning Cardiology

Q. Which of the following is not an absolute contraindication for PTMC? A. Moderate MR B. LA clot C. Severe bicommissural calcification D. Wilkins score of 10 Answer: D. Wilkins score of 10 Explanation:  Absolute contraindications of PTMC include- 1. Moderate to severe MR 2. LA clot 3. Severe bicommissural calcification NB: Mild MR and LAA clot are not absolute contraindications for PTMC.

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.