Removal of broken balloon mitral valvotomy coiled guidewire from giant left atrium using indigenous snare.

Balloon mitral valvotomy (BMV) is a safe and effective therapy for rheumatic mitral stenosis. During the procedure, the coiled portion of 0.025 in. stainless steel BMV guidewire broke off within the giant left atrium (LA). Attempts to retrieve the guidewire with various snares failed as it was moving freely within the voluminous LA. We describe a technique wherein the broken guidewire was retrieved with a snare made of 0.014 in. percutaneous transluminal coronary angioplasty guidewire. The mechanism and prevention of this complication and management options are discussed.