Percutaneous mitral commissurotomy

What is PMC?
Percutaneous mitral commissurotomy (PMC) (also known as mitral valvuloplasty) is a minimally invasive procedure to treat mitral stenosis (a narrowing of the mitral valve), without needing open-heart surgery. It is highly effective and increases the valve area sufficiently in 90-97% of cases. Not all narrowed mitral valves are suitable for PMC, and a transthoracic and transoesophageal echocardiogram will have to be performed to see if your valve is suitable. If your valve does not meet the requirements for safe performance of PMC, you will need open-heart surgery to replace the narrowed mitral valve.

How does the procedure work?
The procedure is performed in the cardiac catheterization laboratory. General anaesthesia is required, and a catheter is inserted via your groin. A small hole is made between the left and right atria (the upper chambers of your heart) to reach the mitral valve, whereafter a balloon is placed across the valve and inflated to open the narrowed valve. Most patients can be discharged the following day.

What are the risks?
Complications can occur, including pericardial tamponade or effusion (blood accumulating around the heart) in 0.5-4%, tearing of the valve with leakage, which will require surgical replacement of the valve with open-heart surgery in 0.3-3.3% and stroke in 1.2-2.8%.

What to expect after the procedure
Your groin might be bruised or tender for a few days after the procedure.