Percutaneous Balloon Valvuloplasty

(Percutaneous Commissurotomy)

Pronounced: Purr-cue-TAY-knee-us BA-loon VAL-view-low-PLAS-tee

Definition

Percutaneous balloon valvuloplasty is a procedure done with a needle. It passes a balloon through blood vessels and into the heart. It is used to repair valves in the heart.

Mitral Valve Stenosis

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Reasons for Procedure    TOP

There are four valves of the heart. They help to control the flow of blood in and out of the heart. If they are damaged it can cause problems with blood flow called stenosis. Stenosis may be due to:

  • Birth defects
  • Scarring from disease like rheumatic fever
  • Aging and calcium deposits

Low blood flow can cause symptoms like shortness of breath. Severe loss of blood flow can lead to heart failure and death.

This procedure will help to open the valves. It will improve blood flow for a time at least 2 years. Some people have relief of symptoms much longer. Badly damaged valves may have less relief.

Possible Complications    TOP

Problems from the procedure are rare. All procedures have some risk. Your doctor will review potential problems, like:

  • Bleeding
  • Infection
  • Leaking valve
  • Damage to the heart or other organs
  • Blood clot formation
  • Stroke

Your risk may be increased if you have:

  • Blood clots in your heart
  • Anatomy of your heart is unusual

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

What to Expect    TOP

Prior to Procedure

Your doctor will have done a number of tests on your heart. All of these results will be reviewed before the procedure.

Talk to your doctor about your current medicine. You may be asked to stop taking some medicine up to one week before the procedure.

Anesthesia

Local anesthesia or mild sedation are used. Local anesthesia will numb the area. Sedation will help you relax but you will be awake.

Description of the Procedure    TOP

You will be lying down in a special procedure room. This room will have an x-ray machines and other equipment.

A blood vessel in your groin or arm will be prepared. The doctor will inject a wire through your skin into a blood vessel and toward you heart. The x-ray machine will show the progress through the blood vessels to the heart. A contrast material can show details of the valve.

The doctor will pass a tube with a deflated balloon over the wire. When the balloon is in the valve, it will be inflated and deflated. This will stretch the tissue. The doctor will repeat inflation until the area is opened. The device will then be removed from the blood vessel.

Immediately After Procedure    TOP

You may need to lie still and flat on your back for a little while. A pressure dressing may be placed over the puncture area.

How Long Will It Take?    TOP

Between 30 minutes and 2 hours

How Much Will It Hurt?    TOP

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

Average Hospital Stay    TOP

Most people are kept overnight. The medical team will monitor for any complications. Your doctor may choose to keep you longer if problems arise.

Postoperative Care    TOP

During your stay, the hospital staff will take steps to reduce your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to reduce your chances of infection such as:

  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incisions

Time to recover is short. There will be a bandage over the puncture site. Strenuous activities will be limited for a short time. The doctor will need to recheck progress in several days to weeks later.

A blood thinner may also be needed.

Call Your Doctor    TOP

It is important for you to monitor your recovery. Alert your doctor to any problems right away. If any of the following occur, call your doctor:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the puncture site
  • Pain that you cannot control with the medicines you have been given
  • Lightheadedness, fainting, or inability to talk
  • Cough, shortness of breath, or chest pain
  • An arm or a leg that turns blue or feels cold
  • New or unexpected symptoms

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

American Heart Association
http://www.heart.org
The Society of Thoracic Surgeons
https://ctsurgerypatients.org

CANADIAN RESOURCES:

Heart and Stroke Foundation of Canada
http://www.heartandstroke.ca

References:

Balloon valvuloplasty. Encyclopedia of Surgery website. Available at:
...(Click grey area to select URL)
Accessed September 15, 2017.
Mitral valve stenosis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115920/Mitral-stenosis. Updated May 31, 2017. Accessed September 15, 2017.
Valvuloplasty. John Hopkins Medicine website. Available at:
...(Click grey area to select URL)
Updated September 15, 2017.
6/2/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
Last reviewed September 2017 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC
Last Updated: 5/9/2018

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