Aims: The objective was to study the clinical, echocardiographic and haemodynamic profile of juvenile rheumatic mitral stenosis (age 20 years), both before and immediately after balloon mitral valvotomy and also to evaluate the safety and efficacy of the procedure in juvenile patients.

Methods: Forty juvenile patients aged 20 years or younger were analysed who underwent balloon mitral valvotomy using Accura balloon in our institution. The procedure was successful in all the patients. The clinical, echocardiographic and haemodynamic parameters were compared pre and post­balloon mitral valvotomy.

Results: New York Heart Association functional class was II and III in 62.5% and 37.5% respectively. Atrial fibrillation was not seen in the juvenile group. Mitral valve deformity asper Wilkins Score was 8.57±0.67. Mitral valve area index by 2D echo was 0.62 ± 0.097 cm2/m2 and was larger (1.38 ± 0.19) after the procedure (p value < 0.0001). Mitral valve gradient (19.85±7.31 mm hg) and mean PASP (70.15±19.2 mm hg) was higher before balloon mitral valvotomy, after balloon mitral valvotomy the values were 7.45 ± 2.57 (P < 0.001) and 40.48±10.30 respectively (p = 0.0001). The mean value for left atrial pressure was 27.48±6.02 and 14.95±5.92 both pre and post­balloon mitral valvotomy (P value 0.0001 and 0.0001 respectively). The procedural success was 95%.

Conclusion: Balloon mitral valvotomy is safe and effective in young with rheumatic mitral stenosis and provides better immediate results.