Acute mitral insufficiency after percutaneous commissurotomy

Acute rheumatic fever (ARF) is still a common disease in developing countries.In Tunisia the incidence of RAA has steadily declined. This epidemiological improvement is linked to the national program to combat AAR long considered a major public health problem.Rheumatic valvulopathies essentially mitral stenosis play a major role in our country.Percutaneous mitral commissurotomy is the treatment of choice for pure narrowing (MR). It removes the obstruction with less morbidity and mortality than surgical techniques.However it can be complicated by acute mitral insufficiency (MI) requiring emergency surgery.Surgery is performed under CEC with the aorta clamped. The aim of a heart-lung bypass machine is to temporarily replace the pumping and hematosis functions of the heart and lung respectively. This makes it possible to open the heart chambers and perform surgery on a stopped bloodless heart.