by Polsdorfer R
(Percutaneous Commissurotomy)

Definition

Percutaneous balloon valvuloplasty is a procedure to improve a heart valve. A balloon will help to open a stiff heart valve.

Mitral Valve Stenosis
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Reasons for Procedure

This procedure is done to improve blood flow through a heart valve. It is done to treat a condition called stenosis . Better blood flow will relieve symptoms. For most, the improvement will last at least 2 years.

This procedure is not appropriate for all stenosis. Some will require open heart surgery instead.

Possible Complications

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 of complications may be increased if you have:

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

Certain factors can increase the risk of complications. Talk to your doctor about factors that may increase your risk such as:

What to Expect

Prior to Procedure

There are many tests that will be done before the procedure. They will help determine your heart health and valve damage.

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

Anesthesia

Local anesthesia will numb the area. Sedation medicine 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.

A blood vessel in your groin or arm will be prepared. A wire will be placed through your skin to the blood vessel. It will be passed through the blood vessel until it reaches the heart valve. The doctor can watch the progress of wire with the x-rays. A tube with a balloon tip will be passed over the wire. A dye may be injected through the device. This will help the doctor see the area and make sure the device is in the right place. The balloon will then be inflated and deflated. The inflation may need to be repeated. The device will then be removed from the blood vessel. A dressing will be placed over the puncture site.

Immediately After Procedure

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?

Between 30 minutes and 2 hours

How Much Will It Hurt?

You may feel some discomfort when the balloon is inflated. It is usually minor.

Average Hospital Stay

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

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

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

Health Canada  https://www.canada.ca 

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

References

Balloon valvuloplasty. Encyclopedia of Surgery website. Available at: http://www.surgeryencyclopedia.com/A-Ce/Balloon-Valvuloplasty.html. Accessed September 14, 2020.

Mitral valve stenosis. EBSCO DynaMed website. Available at:  http://www.dynamed.com/topics/dmp~AN~T115920/Mitral-stenosis . Accessed September 14, 2020.

Valvuloplasty. John Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/test%5Fprocedures/cardiovascular/valvuloplasty%5F92,P07990. Accessed September 14, 2020.

6/2/2011 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T905141/Treatment-for-tobacco-use : 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.

Revision Information