Figure 108

Sequence of percutaneous mitral valvotomy.
A. Floating balloon catheter in position across the atrial septum through the mitral and aortic valves. The tip is in the ascending aorta.
B. The 0.038-in transfer guide wire has been passed through the floating balloon catheter. The floating balloon catheter has been removed.
C. An 8-mm dilating balloon catheter enlarging the atrial septal puncture site.
D. Two 20-mm dilating balloon catheters advanced into position across the stenotic mitral valve over two separate 0.038-in transfer guide wires.
E. Partially inflated dilating balloon catheters across the mitral valve. Note the "waist" produced by the stenotic vlave (arrows).
F. Fully inflated dilating balloon catheters in position across the mitral valve. (A. septum= atrial septum; AV=aortic valve; MV= mitral valve.)

Gaasch, W.H., M.D., O'Rourke, R.A., M.D., Cohn, L.H., M.D., Rackley, C.E., M.D., Mitral Valve Disease, Hurst's The Heart, 8th edition, 1994, p 1568.