Percutaneous transvenous mitral commissurotomy via left femoral vein approach--exploring an unusual approach for left atrial entry.

Percutaneous transvenous mitral commissurotomy (PTMC) using Inoue technique through a right femoral vein approach (RFVA) is well established. Left femoral vein approach (LFVA) is traditionally contraindicated because of certain technical issues. We report a case of PTMC successfully done through this unusual approach, which should be reserved exclusively for cases with right femoral vein occlusion. It also opens up the avenue for other interventions requiring a septal puncture, left atrial entry and use of bulky devices.