ABSTRACT Severe mitral stenosis is associated to congestive symptoms, increased pulmonary artery pressure, atrial fibrillation, and thromboembolic events. Among the treatment options, balloon mitral valve repair is the first choice in patients with favorable anatomy. We report a case of mitral valve repair using balloon in a patient with severe mitral stenosis and suprasystemic pulmonary hypertension (systolic pressure of pulmonary artery estimated at 135mmHg). Valve surgery was contraindicated due to functional class III (NYHA), after hospitalization for ischemic stroke.