Echocardiogram after balloon mitral valvotomy

Immediate evaluation after balloon mitral valvotomy is checking the transmitral gradient using the balloon catheter itself. Left atrial pressure can be measured from the tip of the balloon catheter. Left ventricular diastolic pressure can be obtained by pushing the pigtail catheter in the aorta into the left ventricle. Difference between the two gives the transmitral gradient, which would have reduced dramatically after a successful balloon valvotomy. A tall V wave in the left atrial tracing indicates significant mitral regurgitation. If echocardiogram is available in the cathlab, it can give more detailed information and can exclude a pericardial effusion, which can occur rarely.