Overview of Balloon Valvuloplasty

Balloon valvuloplasty is a heart procedure used to open up narrow or stiff heart valves, like the aortic or mitral valves. This procedure uses a special tube called a catheter that has a balloon on the end. The term “balloon valvotomy” is another way of referring to this procedure.

It’s considered less invasive because doctors place the catheter into a blood vessel in your groin, allowing them to reach the heart without needing major surgery. With this approach, they don’t have to replace the valve entirely through an open surgery involving the chest.

There are different types of balloon valvuloplasty, depending on which heart valve needs to be fixed:

– Percutaneous balloon tricuspid valvuloplasty: for the tricuspid valve.
– Percutaneous balloon pulmonary valvuloplasty: for the pulmonary valve.
– Percutaneous balloon mitral valvuloplasty: for the mitral valve.
– Percutaneous balloon aortic valvuloplasty: for the aortic valve.

Anatomy and Physiology of Balloon Valvuloplasty

The heart is a powerful organ located in your chest that pumps blood. It has four sections or “chambers” and uses valves to control the flow of blood from one chamber to another. Here is a list of these four types of valves:

  • Tricuspid valve: it’s found between the right top and bottom chambers of the heart.
  • Pulmonary valve: this is located between the bottom right chamber and the tube that carries blood to the lungs.
  • Mitral valve: also known as a two-flap valve, it’s between the top and bottom left chambers.
  • Aortic valve: this valve is between the bottom left chamber and the main artery that carries blood from your heart to the rest of your body.

As we get older, or if we experience inflammation or infection of the valves, these van become stiff and hardened. This condition or some birth defects can hinder the blood flow from one heart chamber to another.

Why do People Need Balloon Valvuloplasty

Balloon valvuloplasty is a procedure used to open up narrowed heart valves (a condition called valvular stenosis). The procedure can treat narrowing in several different heart valves, including the tricuspid, pulmonary, mitral, and aortic valves. However, sometimes the potential risks of the procedure may outweigh the potential benefits. Here are the times when balloon valvuloplasty might be used for different kinds of valvular stenosis:

Tricuspid Valve Stenosis

Tricuspid stenosis is a condition where there is narrowing of the tricuspid valve in the heart. For severe tricuspid stenosis patients, doctors generally prefer to replace the valve with surgery. This is primarily because the most common cases accompany another condition known as tricuspid regurgitation, and the balloon procedure can even worsen this condition. However, if the patient’s condition is too severe for surgery and they have a type of tricuspid stenosis with mild regurgitation, doctors might prefer the balloon procedure.

Pulmonary Valve Stenosis

When the pulmonary valve, which controls blood flow from the heart to the lungs, becomes narrow, it’s known as pulmonary stenosis. A specific balloon procedure called percutaneous balloon pulmonary valvulotomy (BPV) is the preferred treatment for moderate to severe cases. It’s often the first choice for treating typical narrow pulmonary valves, especially severe cases. BPV is also the preferred treatment for newborns with critical pulmonary stenosis.

Mitral Valve Stenosis

Mitral valve stenosis, the narrowing of the mitral valve that controls blood flow out of the heart’s left side, may be treated with a balloon valvuloplasty. The procedure suits patients with severe mitral stenosis, a flexible, non-calcified mitral valve, symptoms, absence of a clot in the left atrium of the heart, and little to no mitral regurgitation. Older patients or those at high risk for surgery also usually receive this procedure. The treatment is most commonly performed on patients with rheumatic mitral stenosis, and there is very little experience with the procedure on congenital mitral stenosis.

Aortic Valve Stenosis

Treating aortic valve stenosis with a balloon procedure is limited, particularly when the valve is calcified. However, the procedure may be used as a temporary treatment to ease severe symptoms of aortic stenosis before a patient undergoes surgical or transcatheter aortic valve replacement. It can also be used for patients with severe symptoms who need non-heart related surgery urgently. For younger adults and children with congenital non-calcified aortic stenosis, BAV is usually the first-choice treatment.

When a Person Should Avoid Balloon Valvuloplasty

There are some situations where a procedure known as percutaneous balloon valvuloplasty isn’t safe to do. This procedure involves inserting a balloon into a heart valve to make it wider. However, it’s not advised if:

– There’s medium to severe valvular regurgitation, a condition where the heart valves don’t close properly, causing blood to flow backward.

– There’s infective endocarditis, where the heart’s inner lining is infected.

– There are unusual growths in the heart, such as vegetation (a cluster of blood cells, bacteria, and other substances) or a tumor.

– The person has an irreversible noncardiac disease that greatly shortens their life.

Preparing for Balloon Valvuloplasty

Patients are usually admitted to the hospital a day before their procedure to prepare for it properly. During this time, doctors will ask about your medical history, taking note of any heart or lung conditions you might have. They’ll also ask about your age, weight, height, any medicine you’re currently taking, including blood thinners, and any other existing health conditions. It’s important you share any past allergies, any complications you might have had during previous surgeries, and if anyone in your family ever had issues with anesthesia. Your doctor will also ask about your social life and sexual history. This information helps doctors prepare for the surgery and anticipate any potential complications. On the night before the surgery, you are not allowed to eat or drink anything after midnight, and should not consume anything else until after the procedure is completed. This preparation helps ensure a successful procedure.

How is Balloon Valvuloplasty performed

The process begins with a local anesthetic injection at the place where the catheter, which is a small flexible tube, will enter the body. On top of this, mild relaxing medications are also given through an IV (a way to get medicine directly into your veins), to help ensure your comfort before the operation begins. The next step involves the doctor pinpointing the exact spot just above a blood vessel in the groin region, where they can safely introduce the catheter.

After this, a guide (known as an introducer) is inserted into the blood vessel, which will later help in guiding the catheter through the body and into the heart. Once the catheter is in place within your heart, the doctor then begins to inject a special kind of dye. This dye helps make it easier for the doctor to see exactly where the catheter and heart valve are located inside your body, using an IV line and some medical imaging technology.

As soon as the catheter and heart valve are in the required positions, a balloon is inflated. This balloon helps to push open the blocked valve leaflets – which are like tiny doors within the heart valve that don’t open correctly due to calcium deposits. By breaking apart these deposits, the balloon effectively removes the blockage or ‘stenosis.’

After the calcified deposits are successfully broken down and the blockage is cleared, the doctor then deflates the balloon and removes the catheter from your body.

Possible Complications of Balloon Valvuloplasty

There are a number of potential problems that can occur with balloon valvuloplasty, a procedure used to widen a heart valve that has become narrow. Here are some of the most common issues:

* Bleeding or blood clot formation where the catheter (a thin, flexible tube) is inserted
* Infection at the spot where the catheter is put in
* Damage to a blood vessel if many attempts are needed to insert the catheter
* An allergic reaction to the contrast dye, a type of dye used to make the inside of the body visible in medical pictures
* Arrhythmia, which means the heart isn’t beating normally
* Stroke, which happens when blood flow to a part of the brain is cut off
* Valve rupture, a serious problem where the heart valve tears and requires open heart surgery to fix
* Ventricular rupture, another serious problem where a part of the heart tears
* Valve regurgitation, when the heart valve doesn’t close all the way and allows blood to flow backward.

What Else Should I Know About Balloon Valvuloplasty?

Balloon valvuloplasty is a less intense procedure than open-heart valve replacement. Even so, it doesn’t replace the need for valve replacement surgery.

There aren’t any studies that compare balloon tricuspid valvuloplasty (a treatment for a condition where the valve between the two right heart chambers doesn’t open properly) with surgical tricuspid valve replacement. So, mostly, doctors prefer to do valve surgery. But in high-risk cases, or if the valve leakage is moderate to severe along with tricuspid stenosis, balloon tricuspid valvuloplasty can be considered.

Pulmonary stenosis is a common birth defect where the flow of blood from the right heart chamber to the lungs is blocked. Whether we need to treat pulmonary stenosis in children mainly depends on how severe the blockage is. Mild pulmonary stenosis doesn’t need any treatment. But for moderate and severe cases, balloon pulmonary valvuloplasty is usually the treatment of choice.

In clinical trials comparing percutaneous balloon mitral valvuloplasty (procedure to widen a narrow heart valve) with open and closed surgical commissurotomy (surgery to correct a narrow heart valve), it was found that balloon mitral valvuloplasty was as good as, or better than, surgery for patients who needed valve surgery.

As for aortic stenosis (narrowing of the heart’s aortic valve) due to calcification, percutaneous balloon aortic valvuloplasty has a limited role. However, it is the first-line therapy for children and younger adults with aortic stenosis due to a congenital disease (generally caused by a bicuspid commissural fusion) that does not involve significant valve calcification.

Frequently asked questions

1. What type of balloon valvuloplasty procedure will be performed on me? 2. What are the potential risks and complications associated with balloon valvuloplasty? 3. How long is the recovery period after balloon valvuloplasty? 4. Will I need any follow-up procedures or treatments after balloon valvuloplasty? 5. Are there any alternative treatment options to balloon valvuloplasty that I should consider?

Balloon Valvuloplasty is a procedure that can help improve blood flow in the heart by treating stiff or hardened valves. It involves inserting a deflated balloon into the affected valve and then inflating it to widen the valve opening. This can help alleviate symptoms and improve overall heart function.

You may need Balloon Valvuloplasty if you have a heart valve that is narrow or stenotic. This procedure can help widen the valve and improve blood flow. However, there are certain situations where Balloon Valvuloplasty is not advised, such as if you have medium to severe valvular regurgitation, infective endocarditis, unusual growths in the heart, or an irreversible noncardiac disease that greatly shortens your life. It is important to consult with your healthcare provider to determine if Balloon Valvuloplasty is the right treatment option for you.

You should not get Balloon Valvuloplasty if you have medium to severe valvular regurgitation, infective endocarditis, unusual growths in the heart, or an irreversible noncardiac disease that greatly shortens your life.

The recovery time for Balloon Valvuloplasty varies depending on the specific procedure and the individual patient. Generally, patients can expect to stay in the hospital for a day or two after the procedure for monitoring and recovery. However, full recovery can take several weeks, during which patients may need to limit physical activity and follow any post-procedure instructions provided by their healthcare team.

To prepare for Balloon Valvuloplasty, the patient is usually admitted to the hospital a day before the procedure. During this time, the doctor will ask about the patient's medical history, including any heart or lung conditions, age, weight, height, current medications, and existing health conditions. The patient should not eat or drink anything after midnight on the night before the surgery.

The complications of Balloon Valvuloplasty include bleeding or blood clot formation, infection, damage to a blood vessel, allergic reaction to contrast dye, arrhythmia, stroke, valve rupture, ventricular rupture, and valve regurgitation.

The symptoms that may require Balloon Valvuloplasty include severe tricuspid stenosis with mild regurgitation, moderate to severe cases of pulmonary valve stenosis, severe mitral stenosis with a flexible, non-calcified mitral valve and absence of a clot in the left atrium, and severe symptoms of aortic stenosis before undergoing surgical or transcatheter aortic valve replacement.

Join our newsletter

Stay up to date with the latest news and promotions!

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

We care about your data in our privacy policy.