Percutaneous Transluminal Mitral Commissurotomy

Percutaneous transluminal mitral commissurotomy (PTMC) is a minimally invasive procedure that is used to treat patients with mitral stenosis.

Mitral stenosis

Mitral stenosis is a condition in which the heart’s mitral valve is narrowed and does not open properly, restricting blood flow. It can make you tired and short of breath among other problems. The most common cause of mitral stenosis is a childhood infection called rheumatic fever.


If left untreated, it can cause:

1.   Heart failure (weakened heart)

2.   Heart enlargement

3.   Atrial fibrillation (irregular heartbeat)

4.   Blood clots and lung congestion

In preparing for surgery your doctor will explain your heart condition, the reason for surgery, the risks associated with the procedure, and the pros and cons of the surgery. Furthermore, please note the following:

  1. It is recommended that you visit your dentist to treat any problems with your teeth and gums as these can cause infection after the surgery. It is important that you tell your dentist that you have heart disease so they can prescribe antibiotics before and after the dental procedures.
  2. Avoid drinking alcohol and smoking cigarettes for at least one month before the surgery.
  3. If you have a history of bleeding easily or clotting problems, or if you or family members have ecchymoses (discolorations on the skin due to bleeding), please inform the doctor.
  4. Avoid certain medications for five to seven days, including anticoagulants and certain heart medication, as recommended by your doctor.
  5. Please inform your doctor about any drug allergies and/or other allergies you have.

1.   An intravenous (IV) line will be started for fluids and medication.

2.   You will be given sedation to make you drowsy and a local anesthetic will be injected at the insertion site, normally the groin.

3.   The doctor will insert a catheter with a small deflated balloon at one end through the artery and up into the mitral valve. X-ray is used to visualize this. A transesophageal echocardiography is used to confirm the location of the balloon.

4.   Once the balloon-tipped catheter is in place, it is inflated and deflated several times. The balloon pushes open the mitral valve and stretches the valve opening, improving blood flow.

5.   The balloon is deflated and the catheter is guided back out of your body.

6.   The procedure takes about 1-2 hours to complete.

  1. You will be closely observed after the procedure. The length of hospital stay will depend on your symptoms and can range from one night to longer.
  2. You may have to lie flat for several hours to avoid bleeding. During this time, pressure may be applied to the incision to prevent bleeding and promote healing
  3. Ask your health care team when you can shower, return to work, and resume other normal activities.
  4. Your puncture site will remain tender for a while. It may be slightly bruised and have a small bump.
  5. Your doctor will likely prescribe medications to prevent blood clots. It is important to follow your doctor’s instructions regarding the blood thinning medications.
  • Bleeding
  • Infection
  • Leaking heart valve
  • Blood clots causing heart attack, stroke, or other problem
  • Damage to the heart or blood vessels
  • Adverse reaction to the medication used
  • Kidney failure
  • Arrhythmias (irregular heartbeat)
  • Death
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  • Bleeding, swelling, or increasing pain at the catheter site
  • Signs of infection such as redness, drainage, or fever
  • Dizziness or fainting
  • Shortness of breath
  • Chest discomfort

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