Bedside percutaneous transseptal mitral commissurotomy under sole transthoracic echocardiographic guidance in a critically ill patient.

Percutaneous transvenous mitral commissurotomy is an effective and safe alternative to surgical treatment, in selected patients of rheumatic mitral stenosis. It is usually performed under fluoroscopic guidance in the catheterization laboratory. We report the successful performance of emergency mitral commissurotomy by the Inoue balloon at bedside under sole transthoracic echocardiographic guidance in a critically ill patient.