Transesophageal echocardiography in percutaneous balloon valvuloplasty for mitral stenosis.

As percutaneous mitral valvuloplasty gains wider acceptance, appropriate selection of patients for this procedure continues to be important. The presence of atrial thrombus is a contraindication, and transesophageal echocardiography provides optimal visualization of the left atrium and atrial appendage to assess for the presence of thrombus. This case report describes a patient in whom left atrial thrombus was suspected based on standard precordial echocardiography. After transesophageal echocardiography demonstrated the structure in question to be a normal portion of the left atrial wall, the patient underwent successful uncomplicated percutaneous mitral valvuloplasty. We recommend transesophageal echocardiography in all patients being considered for percutaneous valvuloplasty for mitral stenosis.