A valvuloplasty is a medical procedure performed to open up a stiff heart valve, causing health complications. Also, known as balloon valvuloplasty, this procedure is very effective in repairing heart valves that have a narrow opening. This happens when the flaps, also known as leaflets, of the valves become thick and fuse, causing a condition called stenosis. Stenosis further blocks or restricts the blood flow through the particular valve. A valvuloplasty is performed to open the narrowed valve and help relieve the symptoms of the patient suffering from stenosis.
The heart typically has four types of valves that lie between each of the pumping chambers. These include:
- Tricuspid valve
- Pulmonic valve
- Mitral valve
- Aortic valve
The valves can become stiffened due to infection such as rheumatic fever, birth defects, and age. A person experiencing a heart valve issue can display the following symptoms:
- Extreme chest pain
- Problem in breathing
- Swollen ankles, feet, or abdomen
- Excessive gain weight due to retention of fluid in the body
Why is valvuloplasty needed?
As specified, a valvuloplasty may be performed to open up a heart valve which has become stiff and narrowed over time. However, not all conditions associated with the stiffness and narrowing of valves can be treated by a valvuloplasty.
That said, the doctor will recommend a valvuloplasty in cases where:
- The patient has serious valve narrowing, causing severe symptoms.
- The mitral valve is narrowed, even if there are no symptoms
- The patient has a narrowed tricuspid or pulmonic valve.
- The patient has aortic valve stenosis
In the case of aortic valve stenosis, the valves can become narrow again even after the valvuloplasty. That is why; this procedure is recommended in this case, only if the patient is too sick for surgery or he/she is waiting for a valve transplant and needs a temporary arrangement.
What is the procedure of a valvuloplasty?
The procedure of a valvuloplasty is fairly simple. In this method, the surgeon places a long, thin tube called a catheter into the body of the patient by making an incision on the arm or groin. This catheter is mounted with a tiny balloon on one end and a high-quality, small camera on the other end. This camera provides images of the inside of the body, allowing the surgeon to direct the catheter to the right place. The surgeon uses special dyes to allow the camera on top of the catheter to provide X-ray images as needed.
Once the catheter reaches the exact place, the tiny balloon on the tip is inflated to widen the earlier narrowed valve and also reduce friction by separating the valve flaps. The doctor may inflate and deflate the balloon more than one time to help the condition. After this is done, the blood flow to the valve is automatically restored. Post this, the doctor deflates the balloon and removes both the catheter and the balloon. However, in some cases, the valve may become stiff again, leading to narrowing and related symptoms. In such cases, an alternative form of treatment such as valve repair or valve replacement will be required.
How is the patient prepared for a valvuloplasty?
Firstly, the doctor will ask to remove all jewellery and objects carried. Only dentures and hearing aids are allowed. After this, the patient is asked to change into a comfortable hospital gown and keep the bladder empty before the valvuloplasty. To begin the surgery, a doctor will place an intravenous line (IV line) in the hand of the patient or the arm to administer the IV fluids. The patient will then be connected with an ECG – electrocardiogram – to help the doctor assess the electrical activity of the heart, as well as check vitals, including blood pressure, breathing rate, pulse, etc. The patient is given a sedative or local anaesthesia through the IV line to help relax as the final preparation step for valvuloplasty.
What are the risks involves in a valvuloplasty?
Some of the risks and complications which may arise post a valvuloplasty include:
- Chances of bleeding at the site of the incision
- Infection at the incision site
- Kidney failure
- Extreme blood loss, requiring blood transfusion
- The worsening condition of valve leakage
- Abnormal heart rhythm
- Possibility of a valve rupture, requiring an open-heart bypass surgery
- Allergic reaction to anaesthesia
- Allergic reaction to the special dye used in X-ray
In some special risky cases, the patient must inform the doctor, such as a pregnant woman should make the doctor aware of the pregnancy and discuss the possible complications or impact allowed. In many cases, a valvuloplasty can cause childbirth defects. Also, mothers who are lactating or breast-feeding their child should put this in the notice of the doctor before the surgery to avoid possible complications.
That said, these risks are uncommon and occur only in rare cases. Overall, a valvuloplasty is considered a safe and effective method to treat the valve issue.