Table 8. Contraindications for percutaneous mitral commissurotomy in rheumatic mitral stenosisa.
| Contraindications |
|---|
| MVA >1.5 cm2 a |
| LA thrombus |
| More than mild mitral regurgitation |
| Severe or bi-commissural calcification |
| Absence of commissural fusion |
| Severe concomitant aortic valve disease, or severe combined tricuspid stenosis and regurgitation requiring surgery |
| Concomitant CAD requiring bypass surgery |
| CAD: coronary artery disease; LA: left atrium/left atrial; MVA: mitral valve area; PMC: percutaneous mitral commissurotomy. aPMC may be considered in patients with valve area >1.5 cm2 with symptoms that cannot be explained by another cause and if the anatomy is favourable. |