Valvuloplasty

Overview

Valvuloplasty is a medical procedure aimed at rectifying a narrowed opening in a heart valve.

The heart comprises four valves—the aortic, mitral, tricuspid, and pulmonary valves—each responsible for regulating blood flow through the heart. When a valve narrows (a condition known as stenosis), the valve leaflets may thicken or stiffen, hindering proper blood flow.

Valvuloplasty seeks to enhance blood flow through the affected heart valve and alleviate symptoms associated with valve disease, such as breathlessness or chest pain.

This procedure may also be referred to as balloon valvuloplasty, balloon valvotomy, or percutaneous balloon

Reasons for undergoing the procedure

Valvuloplasty is a surgical procedure utilized to address the narrowing of heart valves, also known as valve stenosis. It serves as a treatment option for various types of valve stenosis, including aortic, mitral, pulmonary, and tricuspid valve stenosis. Without intervention, these conditions can lead to complications such as irregular heartbeats (arrhythmias) and heart failure.

The decision to undergo valvuloplasty is typically made after careful consideration between you and your healthcare provider, taking into account the specific type and stage of your heart valve disease. While severe valve narrowing causing symptoms often warrants valvuloplasty, it may also be recommended in cases where the disease isn’t severe or when symptoms are absent.

Furthermore, the choice to proceed with valvuloplasty may vary depending on the affected valve. For instance, valvuloplasty is commonly recommended for individuals with aortic valve stenosis who are too unwell for surgery or awaiting valve replacement, despite the likelihood of the aortic valve narrowing again in adults post-procedure.

Risk

A valvuloplasty has the same potential for infection and bleeding as any other surgical surgery. Patients should inform their healthcare provider if they are pregnant or suspect they may become. Pregnant women and their unborn children may be at risk from radiation exposure from X-rays taken during valvuloplasty.

A valvuloplasty may also increase the chance that the heart valve narrows once again. Particular risk factors are dependent upon general health. They might get assistance from the healthcare provider in understanding potential risks or side effects of a valvuloplasty.

Procedure

Valvuloplasty is performed as part of a cardiac catheterization procedure. A balloon-tipped soft, thin tube called a catheter is inserted by the cardiologist into a blood vessel, typically in the groin. The heart’s narrowed valve is precisely where the catheter is inserted. The balloon is inflated once it is in place to open the valve and increase blood flow. The balloon gets deflated and the catheter containing it is taken out.

Valvuloplasty may lessen symptoms and enhance heart blood flow. Valvuloplasty may lessen symptoms and increase the heart’s ability to pump blood. The valve could narrow again. In the future, the patient might require a second valvuloplasty or another cardiac treatment, like valve replacement or repair.

Before the procedure

The patient will receive detailed instructions from the healthcare provider on how to get ready for a valvuloplasty. Typically, beginning the night before the surgery, individuals must fast (not eat or drink). They might have to temporarily stop taking any medications that thin blood (anticoagulants).

Wearing metal jewelry or detachable retainers the day of the procedure is not recommended. The healthcare provider administers anesthesia, or sedative medication, to the patient as soon as they arrive at the hospital to help them relax. During the process, they are typically awake.

During the procedure

The valvuloplasty is done by a cardiologist. As the surgery progressed, the cardiologist:

• Inserts a sheath, a tiny, hollow tube, through a blood vessel in the shoulder, arm, or groin.
• Passes a catheter through the sheath while its balloon is deflated.
• Introduces a contrast agent and guides the catheter to the heart valve using X-rays.
• Inflate the balloon in order to widen the heart valve.
• Takes out the catheter and seals the insertion site using surgical adhesive or small sutures.

The cardiologist may use the sheath for up to six hours at a period. If they are at risk of bleeding or need to wait for the effects of blood thinners to wear off, they might decide to proceed in this manner.

After the procedure

Following the procedure, you’ll be taken to a recovery area. If the catheter was inserted through your groin, it’s important to refrain from bending your leg for a few hours. You may need to lie in bed for approximately two to six hours, which can vary depending on individual factors.

It’s essential to drink plenty of water to help flush out the contrast dye from your system. While on bed rest, you’ll be provided with a urinal or bedpan for convenience.

Typically, you’ll be able to start moving around several hours after the valvuloplasty. Most individuals are discharged and able to return home the following day.

Outcome

Valvuloplasty improves heart function by increasing blood flow. This process might help delay or prevent the need to replace the valve.

The following are some advantages of minimally invasive cardiac therapy over open heart surgery:

• Quick recovery.
• Minimal scarring.
• Decrease chance of complications.
• Less painful.

When surgery is recommended by the healthcare provider, valvuloplasty is not an alternative for that procedure.
The length of recovery depends on a number of factors, such as general health and the condition of the heart. For five to seven days, the patient will often need to refrain from swimming and other physically demanding activities. A week later, a lot of people can go back to work. If the patient has a profession that requires physical exertion or manual labor, they might have to wait longer. Resuming all of the regular activities can take up to eight weeks.

Call the healthcare provider immediately following a valvuloplasty if the patient has:

• Bleeding at the incision site.
• Chest pain.
• Dizziness or fainting.
• Discharge at the incision site.
• Fever
• Increase in weight for more than 3 pounds a day.
• Nausea or vomiting.
• Swelling.