Successful percutaneous balloon mitral valvuloplasty in patients with left atrial appendage thrombus

Percutaneous balloon mitral valvuloplasty (PBMV) has become the treatment of choice for patients with symptomatic mitral stenosis since its successful use by Inoue et al. in 1984. One of contraindications to this technique is the presence of thrombus in the left atrium (LA) or left atrial appendage (LAA). Nevertheless, there are some publications indicating that Inoue technique can be safely performed in patients with LAA thrombus. In this report, we describe two patients with rheumatic mitral stenosis referred for PMBV and were found to have LAA thrombus. Despite the presence of LAA thrombus, successful PMBV, with the help of transthoracic echocardiography (TTE), was undertaken without complications.