AccScience Publishing / BH / Volume 2 / Issue 1 / DOI: 10.36922/bh.1701
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Percutaneous management of Lutembacher’s syndrome: A case report

Abhimanyu Uppal1* Rambabu Sharma2 Gyarsi L. Sharma1 Ashok Garg1
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1 Department of Cardiology, Jaipur Heart Institute, Jaipur, Rajasthan, India
2 Department of Pediatrics, JK Lone Hospital, SMS Medical College, Jaipur, Rajasthan, India
Brain & Heart 2024, 2(1), 1701
Submitted: 28 August 2023 | Accepted: 15 November 2023 | Published: 6 February 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( )

The definitive percutaneous management of Lutembacher’s syndrome (LS) is a recognized alternative to surgery in selected cases. This intervention involves balloon mitral valvuloplasty (BMV) followed by device closure of the atrial septal defect (ASD). However, despite its recognition, certain challenges inherent to the procedure have not been highlighted in the majority of earlier case reports. The subject of the present case is a 30-year-old male diagnosed with LS who underwent definitive percutaneous treatment. The coexisting ASD required improvisation to facilitate balloon insertion across the mitral valve using the modified Inoue technique. Furthermore, the ASD device was deliberately oversized to prevent device embolization. This case highlights that percutaneous management of LS is not merely a combination of BMV and device closure procedures. Instead, the unique anatomic and hemodynamic features of LS should be considered when formulating treatment strategies for these patients.

Atrial septal defect
Mitral stenosis
Modified Inoue technique
Balloon manipulation
  1. Bhati BS, John S, Munshi SC, Gupta RP, Sukumar IP, Cherian G. Coexistent mitral valve disease with left-to-right shunt at the atrial level. Results of surgical treatment in 15 cases. J Thorac Cardiovasc Surg. 1970;60(2):174-187.


  1. Ruiz CE, Gamra H, Mahrer P, Allen JW, O’Laughlin MP, Lau FY. Percutaneous closure of a secundum atrial septal defect and double balloon valvotomies of a severe mitral and aortic valve stenosis in a patient with Lutembacher’s syndrome and severe pulmonary hypertension. Cathet Cardiovasc Diagn. 1992;25(4):309-312. doi: 10.1002/ccd.1810250411


  1. Joseph G, Abhaichand Rajpal K, Kumar KP. Definitive percutaneous treatment of Lutembacher’s syndrome. Catheter Cardiovasc Interv. 1999;48(2):199-204. doi: 10.1002/(sici)1522-726x(199910)48:2<199:aid-ccd17>;2-h


  1. Ho CL, Liang KW, Fu YC, et al. Transcatheter therapy of Lutembacher syndrome. J Chin Med Assoc. 2007;70(6): 253-256. doi: 10.1016/S1726-4901(09)70369-7


  1. Bhambhani A, Somanath HS. Percutaneous treatment of lutembacher syndrome in a case with difficult mitral valve crossing. J Invasive Cardiol. 2012;24(3):E54-E56.


  1. Vadivelu R, Chakraborty S, Bagga S. Transcatheter therapy for Lutembacher’s syndrome: The road less travelled. Ann Pediatr Cardiol. 2014;7(1):37-40. doi: 10.4103/0974-2069.126551


  1. Olasinska-Wisniewska A, Grygier M. Antithrombotic/ antiplatelet treatment in transcatheter structural cardiac interventions-PFO/ASD/LAA occluder and interatrial shunt devices. Front Cardiovasc Med. 2019;6:75. doi: 10.3389/fcvm.2019.00075


  1. Meier B. Modified inoue technique for difficult mitral balloon commissurotomy. Cathet Cardiovasc Diagn. 1992;26(4):316-318. doi: 10.1002/ccd.1810260414


  1. Perloff JK. Atrial septal defect. In: The Clinical Recognition of Congenital Heart Disease. 4th ed. Philadelphia, PA: W.B. Saunders; 1994. p233-299. doi: 10.1016/S0022-3476(95)70471-X


  1. Kamana VK, Shetty R, Krishnan AM, Chowdary RK, Malpe UP. Is transoesophageal echocardiography necessary for the percutaneous management of lutembacher syndrome: A case report. J Clin Diagn Res. 2016;10(10):OD08-OD09. doi: 10.7860/JCDR/2016/20582.8688


  1. Mehan VK, Meier B. Impossibility to cross a stenotic mitral valve with the Inoue balloon: Success with a modified technique. Indian Heart J. 1994;46(1):51-52.


  1. Inoue K, Feldman T. Percutaneous transvenous mitral commissurotomy using the lnoue balloon catheter. Cathet Cardiovasc Diagn. 1993;28(2):119-125. doi: 10.1002/ccd.1810280206


  1. Manjunath CN, Srinivasa KH, Patil CB, Venkatesh HV, Bhoopal TS, Dhanalakshmi C. Balloon mitral valvuloplasty: Our experience with a modified technique of crossing the mitral valve in difficult cases. Cathet Cardiovasc Diagn. 1998;44(1):23-26. doi: 10.1002/(sici)1097-0304(199805)44:1<23:aid-ccd6>;2-9


  1. Zureikat HY, Karsheh IE, Naber NM, Najjar SM, el-Dibs NR, Salch SS. Mitral balloon valvuloplasty using a retrograde transventricular approach via the brachial artery. Cathet Cardiovasc Diagn. 1989;17(3):183-185. doi: 10.1002/ccd.1810170313


  1. Cheng TO, Holmes DR Jr. Percutaneous balloon mitral valvuloplasty by the Inoue balloon technique: The procedure of choice for treatment of mitral stenosis. Am J Cardiol. 1998;81:624-628. doi: 10.1016/s0002-9149(97)00978-8
Conflict of interest
The authors declare that they have no competing interests.
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Brain & Heart, Electronic ISSN: 2972-4139 Published by AccScience Publishing