Simplified approaches to percutaneous mitral commissurotomy (PTMC) using conventional Inoue balloon included puncturing the atrium septal by “hash” technique and physiologically shaping the stylet for driving the balloon across a stenosed mitral valve. “Hash” technique simplified and improved the safety of septal puncture procedure with or without artery access. R-shaped stylet improved the successfulness of crossing a balloon in complex scenarios such as a giant left atrium or low position of septal puncture. Here is the summary of a physiological PTMC approaches using Inoue balloon to improve the safety, feasibility, procedure length of the PTMC procedure.
