Generally accepted contraindications for BMC are the presence of severe mitral regurgitation (MR) (>3+ by Sellers’ angiographic criteria and left atrial thrombus identified by echocardiography. However, our studies have demonstrated that in those patients with left atrial thrombus confined to the appendage area, PTMV can be performed safely in experienced hands.

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Successful Percutaneous Transvenous Catheter Balloon MitraI Commissurotomy After Warfarin Therapy and Resolution of Left Atrial Thrombus
By Jui-Sung Hung, MD, Fun-Chung Lin, MD, and Cheng-Wen Chiang, MD

Safety of Inoue Balloon Mitral Commlssurotomyin Patients With Left Atrial Appendage Thrombi
By Kuo-Ho Yeh, MD, Jui-Sung Hung, MD, Chiung-Jen Wu, MD, Morgan Fu, MD, Sarah Chua, MD, and Ming-Shyan Chern, MD