Surgical Electrocautery Facilitated Transseptal Percutaneous mitral balloon commissurotomy (PMBC)

A 60-year-old lady with history of 2 times of Percutaneous mitral balloon commissurotomy (PMBC) presented with symptomatic severe Mitral stenosis and recently failed PMBC due to failure of inter-atrial septostomy with standard approach.
A standard surgical RF generator and a standard transseptal Brockenbrough needle were applied to puncture the thick septum and PMBC was successfully done.