We thank Choudhary and his colleagues for their interest in our article. 1 Experience in our center and also reported by others 2 shows that the majority of patients with severe subvalvular disease achieve a satisfactory outcome with percutaneous transmitral commissurotomy (PTMC). Hence we believe that we have to look beyond the role of undiagnosed subvalvular disease as the sole mechanism in producing mitral regurgitation (MR) after PTMC. This allows us to further clarify our hypothesis.
Dr. Praveen Varma and Neema, P. Kumar, “Post percutaneous transmitral commissurotomy mitral regurgitation; Underestimated Subvalvar Disease. Reply to editor”, J Thorac Cardio Vasc Surg, vol. 131, no. 4, pp. 927-928, 2006.