Percutaneous Balloon Valvuloplasty Overview

Percutaneous balloon valvuloplasty is done to open a constricted heart valve with a balloon.

Mitral Valve Stenosis © 2008 Nucleus Medical Media, Inc.

Prior to Procedure

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. This includes whether the valve is calcified, how thick it is, and how narrow the opening is. Many valves cannot be fixed with this technique. They will require open heart surgery instead.

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

• Aspirin or other anti-inflammatory drugs
• Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)

Anesthesia

Only local anesthesia and perhaps mild sedation are used. Local anesthesia will numb the area. Sedation will help you relax.

Description of the Procedure

You will be lying down in a special procedure room. There will be x-ray machines and surgical equipment. Depending on the valve that needs work, a blood vessel in your groin or arm will be prepared. A thin device (wire) will be placed through your skin to the blood vessel. It will be passed through the blood vessel until it reaches the valve. Progress will be monitored by x-rays. A tube with a balloon tip will be threaded over the wire. A contrast material may be injected through the device. This will help to visualize the area and make sure the device is in the right place. Once the balloon is in the valve, it will be inflated and deflated. Your doctor may need to repeat the inflation. The device will then be pulled back out of the blood vessel.

Immediately After Procedure

You will likely need to lie still and flat on your back for a period of time. A pressure dressing may be placed over the puncture area. It is important to follow the nurses' directions.

How Long Will It Take?

Between 30 minutes and two hours

How Much Will It Hurt?

You may feel some minor discomfort when the balloon is inflated. Some people report a flushing sensation if contrast is injected.

Average Hospital Stay

Most people are kept overnight for observation. Your doctor may choose to keep you longer if complications arise.

Postoperative Care

Recovery time is minimal. 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 doctor will want to see you several days or weeks later.

Be sure to follow your doctor's instructions.

RESOURCES:

Inova Heart Center
http://www.inova.org/

Northwestern Memorial Hospital
http://www.nmh.org/

CANADIAN RESOURCES:

Mount Sinai Hospital, Canada
http://www.mtsinai.on.ca/

University of Ottawa Heart Institute
http://www.ottawaheart.ca/

References:

American Heart Association. Percutaneous balloon aortic valvuloplasty: acute and 30-day follow-up results in 674 patients from the NHLBI balloon valvuloplasty registry. Circulation. 1991;84:2383-2397.

Chen CR, et al. Percutaneous balloon valvuloplasty for pulmonic stenosis in adolescents and
adults. N Engl J Med. 1996;33:21-25.

Kiwan Y, et al. Mitral balloon valvuloplasty by inoue technique without echocardiographic standby. Available at: http://www.kfshrc.edu.sa/annals/145/93189.html . Accessed August 23, 2005.

The Merck Manual of Geriatrics website. Available at: http://www.merck.com/mrkshared/mmg/sec11/ch96/ch96e.jsp . Accessed August 23, 2005.

Tarka EA, Blitz LrR, Herrmann HC. Hemodynamic effects and long-term outcome of percutaneous balloon valvuloplasty in patients with mitral stenosis and atrial fibrillation. Clin Cardiol. 2000;23:673-677.