Valvuloplasty

(Also called Balloon Valvuloplasty)

Overview

Valvuloplasty is a procedure used, in certain circumstances, to treat valvular heart disease. To better understand how valvular heart disease affects the heart, a review of basic heart anatomy and valve function follows.

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The heart is a pump made of muscle tissue. The heart has four pumping chambers: two upper chambers, called atria, and two lower chambers, called ventricles. The right atrium pumps blood into the right ventricle, which then pumps the blood into the lungs where wastes such as carbon dioxide are given off and oxygen and other nutrients are taken into the blood.

From the lungs, the blood flows back into the left atrium, is pumped into the left ventricle, then is pumped through the aorta out to the rest of the body and the coronary arteries. When the atria are pumping, the ventricles are relaxed in order to receive the blood from the atria. Once the atria have pumped their entire blood load into the ventricles, they relax while the ventricles pump the blood out to the lungs and to the rest of the body.

In order to keep the blood flowing forward during its journey through the heart, there are valves between each of the heart's pumping chambers:

• tricuspid valve - located between the right atrium and the right ventricle.
  
  
• pulmonary (or pulmonic) valve - located between the right ventricle and the pulmonary artery.
  
  
• mitral valve - located between the left atrium and the left ventricle.
  
  
• aortic valve - located between the left ventricle and the aorta.

If the heart valves become damaged or diseased, they may not function properly. Dysfunction of heart valves may be either stenotic (stiff) or insufficient (leaky). When one (or more) valve(s) becomes stiff, or stenotic, the heart muscle must work harder to pump the blood through the valve. Some reasons why heart valves become stenotic include infection (such as rheumatic fever or staph infections) and aging. If one or more valves become leaky, or insufficient, blood leaks backwards, which means that less blood is pumped in the proper direction.

Valvular heart disease may cause the following symptoms:

• dizziness
• chest pain
• breathing difficulties
• palpitations
• edema (swelling) of the feet, ankles, or abdomen
• rapid weight gain due to fluid retention

What is Valvuloplasty?

Valvuloplasty is a procedure used to open a stenotic (stiff) heart valve. In valvuloplasty, a very small hollow tube, or catheter, is advanced from a blood vessel in the groin through the aorta into the heart. Once the catheter is in place in the valve to be opened, a large balloon at the tip of the catheter is inflated until the leaflets (flaps) of the valve are opened. Once the valve has been opened, the balloon is deflated and the catheter is removed.

You are awake during the procedure, although you will receive a small amount of sedating medication prior to the procedure.

Reasons for the Procedure

Valvuloplasty is performed in order to open up a heart valve that has become stiff as a result of disease or the aging process.

Risks of the Procedure

Possible risks associated with valvuloplasty include, but are not limited to, the following:

• bleeding at the catheter insertion site (usually the groin, but the arm may be used in certain circumstances)
  
  
• blood clot or damage to the blood vessel at the insertion site
  
  
• stroke (brain attack) or heart attack due to dislodging of a plaque into the blood circulation during the procedure (rare occurrence)
  
  
• infection at the catheter insertion site
  
  
• pneumothorax (collapsed lung) due to misplaced catheter
  
  
• allergic reaction to the dye
  
  
• kidney failure related to the dye
  
  
• cardiac dysrhythmias

In addition, valvuloplasty should not be performed on a woman who is pregnant or thinks she may be pregnant.

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