Subvalvular apparatus and adverse outcome of balloon valvotomy in rheumatic mitral stenosis.

Background: Balloon mitral valvotomy (BMV) is a well-established therapeutic modality for rheumatic mitral stenosis (RMS). However, there are chances of procedural failure and the more ominous post-procedural severe mitral regurgitation. There are only a few prospective studies, which have evaluated the pathogenic mechanisms for these major complications of BMV, especially in relation to the subvalvular apparatus (SVA) pathology.

Complete heart block following transcatheter closure of ruptured sinus of Valsalva aneurysm.

Ruptured sinus of Valsalva aneurysm (RSVA), a rare form of left-to-right shunt, is being increasingly corrected with transcatheter closure (TCC) with promising immediate and mid-term results. Complete heart block (CHB) following TCC of perimembranous ventricular septal defect is a well-described albeit worrisome complication. We describe a hitherto unreported case of development of CHB following TCC of RSVA that responded to high-dose steroids.