Recently, the shape of the J-tipped stylet used in Inoue balloon mitral valvuloplasty has been altered to form a tighter loop. Consequently, the distal balloon catheter tends to take a more vertical orientation when the stylet is inserted into the catheter during manipulation of the balloon catheter across the mitral valve. We describe a modified method - a vertical approach - to facilitate and expedite crossing of the mitral valve during Inoue balloon mitral valvuloplasty.
