Valvuloplasty

What to Expect

During the Procedure

• Description of the room, monitoring devices, positions, and equipment that will be used - From the holding area, you will be taken to the room where the procedure will actually take place. The room will feel cool. You will lie on a firm but padded x-ray table and you will be connected to equipment that will monitor your heart rhythm, blood pressure, and oxygen levels. A nurse will accompany you at all times. Please feel free to ask questions at any time.

  You will lie flat on your back during the entire procedure. There will be several monitor screens in the room, showing your vital signs (EKG, heart rate, blood pressure, breathing rate, and oxygen level), the images of the catheter being moved through the body into the heart, and the structures of the heart as the dye is injected.
  
  The cath lab is a sterile area, so everyone in the room will wear gowns, masks, and caps. The physician and assistants actually performing the procedure will wear sterile gloves. A large x-ray camera will be above the table to make pictures of the procedure.
  

• Anesthesia - You will be given a sedative medication in your IV prior to the procedure to help you relax. However, you will remain awake during the procedure.
  
  
• Basic description of the procedure:
  
  
  • The cath site (groin or arm) will be cleansed again with antiseptic soap.
    
    
  • Sterile towels and a sheet will be placed around this area.
    
    
  • A numbing medication (lidocaine or xylocaine) will be injected into the skin at the cath site. You may feel some slight stinging at the site for a few seconds after the numbing medication is injected.
    
    
  • Once the numbing medication has taken effect, a sheath, or introducer, is inserted into the blood vessel. This is a plastic tube through which the catheter will be inserted into the blood vessel and advanced into the heart. If the arm is used, a small incision (cut) is made to expose the blood vessel for insertion of the sheath.
    
    
  • It will be very important for you to remain still during the procedure so that the catheter placement is not disturbed and to keep from causing damage to the insertion site.
    
    
  • The valvuloplasty catheter is inserted through the introducer into the blood vessel. The physician advances the catheter through the blood vessels into the heart. This is done by watching the catheter on the monitor and guiding it into the proper structures. The room will be dim, so that the monitors can be seen by the physician and staff.
    
    
  • The catheter is advanced into the valve to be treated. Once the catheter is in place, dye is injected through the catheter into the valve in order to look at the area. As the dye is injected, you may feel a warm sensation. This is only temporary and will disappear quickly.
    
    
  • Your physician will watch the x-ray dye injection on an x-ray monitor, much like a TV screen. At this time, it may also be possible for you to view the x-ray monitor. While these x-rays are taken, your physician may ask you to take a deep breath and hold it for a few seconds.
    
    
  • Once the balloon is in place and has been inflated, you may notice some dizziness or even brief chest discomfort. This should subside when the balloon is deflated. However, if you notice any severe discomfort or pain, such as chest pain, neck or jaw pain, back pain, arm pain, shortness of breath, or breathing difficulty, let the physician know.
    
    
  • The balloon may be inflated and deflated several times in order open the valve.
    
    
  • Once it has been determined that the valve is opened sufficiently, the catheter is removed. However, the sheath, or introducer will be left in for several more hours.
    
    
  • The physician or an assistant will hold pressure on the insertion site for about 15 to 20 minutes so that the blood can begin to form a clot at the site and stop the bleeding. Once the physician or assistant is satisfied that the bleeding has stopped, a very tight bandage will be placed on the site. A sandbag may be placed on top of the bandage for additional pressure on the site, especially if the site is the groin.
    
    
  • You will be assisted to slide from the table onto a stretcher so that you can be taken to the recovery area. Note: You will not be allowed to bend your leg nearest the insertion site, if the insertion was done in the groin, for several hours. To help you remember to keep your leg straight, the knee of the affected leg will be covered with a sheet and the ends will be tucked under the mattress on both sides of the bed to form a type of loose restraint.
    
    
• Procedure time - The valvuloplasty procedure itself will last about two hours, but may take longer, depending on how quickly the physician is able to open the valve with the balloon.
  

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