Percutaneous balloon valvuloplasty involves opening a constricted heart valve using a balloon threaded through blood vessels.
Any of the heart’s four valves can become deformed, either congenitally or because of scarring from disease. Valve deformities can either leak or restrict blood flow. When flow is restricted due to a very small valve opening (a condition called stenosis), the valve needs to be repaired. This used to be done with open heart surgery, but certain valves can be repaired with percutaneous balloon valvuloplasty, a much less invasive procedure.
- Heart valves
- Most frequently the mitral valve that controls blood entering the heart from the lungs
- Aortic and pulmonary valves
- Tricuspid valve (rarely)
Congenitally deformed heart valves or valves scarred by diseases such as
rheumatic fever
can reduce blood flow, leading to heart failure and death. Narrowing of a valve opening is called
stenosis.
Even in patients who are too weak or ill to undergo major surgery, these procedures have a mortality rate less than 5%. Increased risk is associated with:
- Blood clots in the heart
- The anatomy of the valve
- Overall health status
You will have a thorough evaluation to determine your overall condition, the health of your heart, and the exact nature of your valve defect. The success of the procedure depends a great deal on the condition of the valve—whether it is calcified, how thick it is, and how narrow the opening is. Many valves cannot be fixed with this technique and require open heart surgery.
Only local anesthesia and perhaps mild sedation are used.
You will be lying down in a special procedure room similar to a surgical suite. It will be filled with x-ray machines as well as an array of surgical equipment. Depending upon what artery is to be opened, a blood vessel in your groin or arm will be prepared and covered with sterile drapes. The physician will then puncture your numbed skin and thread the long device into your blood vessel until it reaches the valve. Progress will be monitored by x-rays. Dye may be injected through the device to visualize the obstruction and assure that the device is in the right place.
Recovery time is minimal. You will probably spend the night in the hospital to make sure there are no complications, and you will likely be prescribed a medication, like aspirin, to prevent blood clots.
The entire process takes between ½-2 hours.
Inserting the device is like giving blood. Some minor discomfort may accompany the actual ballooning of the valve.
- Need for transfusion
- Leaking valve
- Need for vascular or cardiac surgery
-
Embolic
stroke
(blood clot obstructing blood flow to the brain)
- Other systemic embolus (blood clot obstructing blood flow to an organ or other body part)
- Myocardial infarction
(heart attack)
-
Acute
kidney failure
There will be a bandage over the puncture site. You may be prescribed a “blood thinner” like aspirin. Certain strenuous activities will be limited. Other activities, like exercises and fluid intake, may be encouraged. Your physician will want to see you several days or weeks later.
Depending upon which valve is involved and what condition it is in before the procedure, relief of symptoms can be expected to last at least two years, sometimes much longer.
- Problems with your puncture site—bleeding, swelling, pain, or numbness
- Dizziness, fainting, or symptoms of a stroke
- Chest pain
- Worsening shortness of breath
- An arm or a leg that turns blue or feels cold
- Inability to pass urine
- Fever
Last reviewed November 2007 by J. Peter Oettgen, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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