The basal haemodynamic layout recorded a 23 mmHg mean gradient and a 55 mmHg “v” wave, even if on angiography the regurgitation was quantified as moderate. What drew our attention was an image in the diaphragmatic left ventricular side, originating in the valvular plane, suggesting a severe shortening and chordal fusion (Figure 1A).
A 26 mm Inoue-Balloon Catheter (Toray, Tokyo, Japan) was employed. The post-valvuloplasty angiogram showed massive mitral regurgitation.
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