A narrowed heart valve can make it harder for your heart to pump blood throughout your body. Over time, this can cause heart failure, blood clots or stroke. With balloon valvuloplasty, our team uses minimally invasive techniques to open narrowed heart valves and restore blood flow without open-chest surgery.
What is a Valvuloplasty?
A valvuloplasty (also called a valvotomy) is a minimally invasive structural heart disease treatment to open a narrowed heart valve. Narrowing of heart valves (valve stenosis) can restrict blood flow and cause symptoms such as chest pain or shortness of breath.
In a valvuloplasty, an interventional cardiologist uses a hollow, flexible tube (catheter) to insert a balloon into the narrowed heart valve. When the balloon is in position, the cardiologist inflates it to widen the valve and increase blood flow.
Other names for valvuloplasty include:
- Valvotomy
- Balloon valvuloplasty
- Balloon valvotomy
Who Might Need a Balloon Valvuloplasty?
A balloon valvuloplasty may be a treatment option for people who have symptoms resulting from:
The aortic valve controls blood flow between the lower left heart chamber (ventricle) and the body's main pumping artery (aorta). When this valve narrows, blood doesn't flow through the heart as it should. Our cardiologists may offer valvuloplasty to patients with aortic stenosis who aren't candidates for aortic valve repair and replacement surgery or transcatheter aortic valve replacement (TAVR). Sometimes the aortic valve narrows again after valvuloplasty, so cardiologists may also use this as a temporary treatment before TAVR or surgical valve replacement.
The mitral valve controls blood flow between the upper left heart chamber (atrium) and the left ventricle. Valvuloplasty is usually the treatment of choice for mitral valve stenosis. Our cardiologists also use mitral valve repair and replacement surgery and transcatheter mitral valve replacement (TMVR).
The pulmonary valve controls blood flow from the right ventricle to the lungs. Pulmonary stenosis is often a congenital (present at birth) condition that's treated during childhood. Over time, adult patients may require further treatment. Our cardiologists may use valvuloplasty, pulmonary valve repair and replacement surgery or transcatheter pulmonary valve replacement (TPVR) to treat pulmonary stenosis.
What to Expect During a Valvuloplasty Procedure
Balloon valvuloplasty is an inpatient procedure that takes about an hour. You receive anesthesia to keep you calm and comfortable. The team includes an interventional cardiologist, an interventional echocardiographer and an anesthesia specialist working together to perform a valvuloplasty.
When it's time for the procedure, the team connects you to an electrocardiogram machine that monitors your heart's electrical activity. You also are connected to machines that record your heart rate, breathing, oxygen levels and blood pressure.
During a balloon valvuloplasty, an interventional cardiologist:
- Places a hollow plastic tube called a sheath through a blood vessel in your groin
- Inserts a catheter with a balloon on the tip through the sheath
- Guides the catheter to your heart by watching X-ray and echocardiographic images that show your heart's structures and blood vessels
- Injects a contrast dye through the catheter that highlights the narrowed heart valve
- Positions the balloon in your narrowed heart valve. The interventional cardiologist may ask you to hold your breath for several seconds while they position the balloon. They may need to inflate and deflate the balloon a few times to fully open the valve.
- Inflates the balloon to expand the valve opening
- Once the valve is open, the interventional cardiologist removes the catheter and balloon
Balloon Valvuloplasty Recovery
You can expect to stay in the hospital for one night after a valvuloplasty. You'll need to lie flat for several hours to reduce your risk of bleeding at the catheter insertion site. Your care team will encourage you to drink plenty of water to flush the contrast dye from your system, but you can usually resume your normal diet immediately after the procedure.
Most people experience an immediate improvement in symptoms of valve stenosis, including a decrease in chest pain, fatigue and shortness of breath. It's normal to have a small bruise near the catheter insertion site. Your care team will give you instructions to watch for signs of complications, such as bleeding, swelling or temperature changes at the catheter insertion site. You'll likely need to avoid strenuous activities for a few days after balloon valvuloplasty. Depending on your overall health and the underlying diagnosis, you may be able to resume usual activities within several days.
Complications are rare, but can include significant bleeding, arrhythmia or blood clots. Call your doctor right away if you experience any signs of complications, such as:
- Chest pain or pressure
- Decreased urination
- Fever or chills
- Nausea or vomiting
- Pain, redness or heat at the catheter insertion site
- Swelling in your legs or abdomen
- Weight gain that exceeds three pounds in one day
Your provider may recommend you complete cardiac rehabilitation after a valvuloplasty. Cardiac rehab can help speed your recovery and strengthen your heart. Our rehabilitation specialists provide education, nutrition counseling and gentle exercises in an outpatient setting.
How Long Does a Balloon Valvuloplasty Last?
The results of a valvuloplasty can last decades, but the procedure doesn't cure valve stenosis. If your heart valve narrows again, your cardiologist will discuss your options. You may need medication, a second valvuloplasty or a heart valve replacement procedure.
Balloon Valvuloplasty: The Penn Medicine Advantage
Penn interventional cardiologists are established experts in balloon valvuloplasty techniques. We have decades of published research and continually offer the newest treatments, often before they're widely available. When you choose us, you benefit from:
- History of innovation: Penn was one of the first medical systems in the nation to offer balloon valvuloplasty for mitral valve stenosis. Our history of innovation positions our cardiologists as some of the most experienced in the nation.
- Targeted treatments: We offer a full range of advanced valvotomy treatment options. We perform balloon valvotomies in our state-of-the-art cardiac catheterization laboratory (cath lab) using the Inoue Balloon™ catheter, a catheter designed specifically to treat mitral valve stenosis.
- Team-based care: A team of interventional cardiologists, interventional echocardiographers, anesthesiologists and nurses cares for you. Our team-based, subspecialized treatment approach leads to precise treatment and better outcomes.
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