Mitral valve balloon mitral valvotomy

Overview

Balloon Mitral Valvotomy is a minimally invasive surgery that is sometimes referred to as Percutaneous Balloon Mitral Valvuloplasty (PBMV) or Percutaneous Transvenous Mitral Commissurotomy (PTMC). It comes with the guided insertion of a thin, flexible catheter into the heart through the groin femoral vein. The balloon at the end of the catheter is quickly inflated after it reaches the constricted mitral valve.

This inflation effectively widens the mitral valve leaflets that have narrowed or fused. Balloon Mitral Valvotomy maximizes the flow of blood from the left atrium into the left ventricle by expanding the opening of the mitral valve. This provides a focused and effective treatment by reducing the symptoms brought on by mitral stenosis.

Mitral stenosis is described as a narrowing of the blood flow through the mitral valve, which is located between the left atrium and the left ventricle. This valve is vital to the unidirectional flow of blood from the left atrium to the left ventricle. Effective treatments are crucial because of the resulting effects of mitral stenosis, which include stagnation of blood and symptoms including dyspnea and chest pain. Balloon Mitral Valvotomy shows as an extremely effective treatment for mitral stenosis, reducing symptoms and improving heart blood flow.

Reasons for undergoing the procedure

There is a chance of several implications when the mitral valve contracts to a size smaller than 1.5 square cm. If mitral stenosis is present, there is also a chance of a brain stroke.

People who already have mitral stenosis and are thinking about getting pregnant should also exercise caution.

Breathlessness as a result of constriction of the valves is one of the key symptoms that needs to be attended to. Furthermore, the detection of elevated blood pressure in the lungs, or pulmonary hypertension, by echocardiogram indicates a problem that needs to be evaluated by the healthcare provider.

Risk

Balloon mitral valvotomy, a catheter-based technique, carries a lower risk of complications compared to open heart surgeries like commissurotomy or valve replacement. It’s essential to notify the healthcare provider if the patient is pregnant or suspects pregnancy because valvuloplasty can potentially lead to bleeding or infection. For pregnant individuals and their fetuses, both valvuloplasty and the radiation exposure associated with X-rays during the procedure pose significant risks.

Before the procedure

The healthcare provider will provide the patient with comprehensive instructions on preparing for a valvuloplasty. In preparation, the patient should refrain from eating or drinking the night before the surgery. It may also be necessary to temporarily discontinue any blood-thinning medications or anticoagulants.

On the day of the surgery, it’s essential for the patient not to wear any metal items, such as jewelry or removable retainers. Upon arrival at the hospital, the medical staff will administer anesthesia or sedative medication to ensure relaxation during the procedure. Typically, patients remain awake throughout the process.

During the procedure

Throughout the process of valvotomy, the healthcare provider will:

• Inserts a sheath—a tiny, hollow tube—through a blood vessel in the shoulder, arm, or groyne.
• Inserts a catheter through the sheath using a deflated balloon.
• Use X-rays and a contrast dye injection to guide the catheter to the heart valve.
• Opens the cardiac valve that has constricted by inflating the balloon.
• Close the insertion site using tiny sutures or a specialized surgical adhesive after removing the catheter.

After the procedure

The patient will proceed to a recovery area following the surgery. They will have to wait a few hours before bending their leg if the catheter passed through their groin. Depending on a number of factors, they could lie in bed for two to six hours.

In order to remove the contrast dye from their body, the patient must drink a lot of water. They will need to use a bedpan or urinal while they are on bed rest.

After a valvuloplasty, they can typically move around and get up several hours later. Most individuals go home the following day.

Outcome

Balloon mitral valvotomy aims to improve heart function and blood flow, may be able to delay or prevent valve replacement. Compared to open-heart surgery, this minimally invasive procedure has a number of benefits, such as a quicker recovery, less scarring, a decreased chance of complications, and less pain. It offers a potentially effective way to enhance heart health with the least amount of negative effects on the patient.

The procedure reduces left atrial pressure and improves cardiac output while offering instant symptom relief. In addition, patients with sinus rhythm benefit from improved left atrial pump function, and those with atrial fibrillation benefit from increased reservoir function. These favorable results demonstrate how quickly symptoms can be addressed and heart function can be optimized using balloon mitral valvotomy.

The length of recovery following valvuloplasty depends on a number of factors, including general health and heart condition. Following the treatment, it’s generally advisable to refrain from swimming and strenuous exercise for a period of five to seven days. While many individuals can resume work after about a week, those with physically demanding or labor-intensive jobs may require a more extended recovery period. The full return to one’s regular routine after valvuloplasty may take up to eight weeks due to the comprehensive healing process involved. Achieving a successful recovery hinges on considering individual health factors and diligently following the guidance provided by medical specialists.

If the patient experiences any of the following after the valvuloplasty, contact the healthcare provider immediately:

• Bleeding at the incision site
• Pain or swelling that may be worsen
• Chest pain
• Fever or chills
• Fainting or syncope
• Dizziness
• Nause or vomiting
• There is increase in weight around 3 pounds in a day.