Our heart is an organ that works like a wonderful pump. Inside this pump, there are small gates that help blood flow in only one direction. We call these heart valves. Imagine what happens if one of these gates does not open properly, becomes blocked, or narrowed? Then the heart has to work very hard to pump blood. We call this condition stenosis. So today we are talking about a not-so-complicated treatment method to make such a blocked valve work properly again, that is, to make its opening larger.
Simply put, what is valvuloplasty?
Valvuloplasty is a common procedure used to widen the opening of a narrowed or blocked heart valve. It's very simple. Your doctor will use a small, thin tube called a catheter. The end of this tube has a small balloon attached to it.
This is also called Balloon Valvuloplasty . So, this balloon-shaped tube is passed through one of your blood vessels to the narrowed valve in your heart. Then, when the balloon is inflated, it opens the narrowed valve and makes it larger. When the procedure is done, the balloon is deflated and the tube is removed. Very simple, right?
Sometimes this is called a "valvotomy." However, that name is sometimes used for this balloon procedure as well as for the surgery to enlarge the valve using open-heart surgery. However, in the "valvuloplasty" we are talking about today, no large incision is made.
What conditions is this treatment used for?
This treatment is mainly used to widen a heart valve that has become narrowed (stenosis). This can be done on any of the four main valves in our heart. However, this treatment is most often used for narrowing of the mitral valve and the aortic valve .
Think about it this way. Sometimes this is done as a temporary solution. That is, after this treatment, you may get relief for a while, and then later you may have to undergo a surgery to implant a new valve (Valve replacement).
The important thing is that valvuloplasty is not a new heart valve transplant. It simply repairs the existing valve and enlarges its opening.
How should I prepare before treatment?
Your doctor will give you clear instructions on how to prepare for this. Typically, you will need to do the following:
- Do not eat or drink anything from the night before the treatment (fasting).
- If you are taking blood-thinning medications (anticoagulants), you will need to stop taking them for a while, as your doctor tells you.
- Remove metal jewelry and watches and leave them at home.
When you go to the hospital, the medical team will give you a sedative (anesthesia) to help you relax. Most of the time, you will be awake during this treatment, but you will not feel any pain.
What happens during treatment?
This balloon valvuloplasty procedure is performed by a cardiologist. It usually takes about an hour or a little longer. Let's take a look at what happens during this procedure.
| Steps | A simple explanation of what is happening |
|---|---|
| 1. Inserting the tube | The doctor inserts a small tube called a sheath into a large blood vessel in your groin, arm, or shoulder. |
| 2. Sending the catheter | Inside that tube, a catheter with a tube at the end is carefully passed along the blood vessel to the heart. |
| 3. Taking care of the road | To clearly see the path of this tube through the blood vessels, a special type of 'contrast dye' is injected. This dye makes the inside of the vessels visible when viewed with a machine like an X-ray. |
| 4. Balloon inflation | When the catheter reaches the exact location of the blocked valve, the balloon is inflated with air, which opens the blocked valve and widens it. |
| 5. Removing the tube | Once the valve is dilated, the balloon is deflated and the catheter and balloon are carefully removed. |
| 6. Closing the wound | The site where the tube was inserted is closed with either a small stitch or a special type of surgical glue. |
Sometimes, if there is a risk of bleeding or if you need to wait until the blood- thinning medications wear off, the first inserted tube, called a 'sheath', is left in place for about six hours and then removed.
What are the benefits and risks of this treatment?
As with any medical treatment, there are benefits and risks. Your doctor will explain these to you in detail based on your specific health condition.
| Benefits | Possible risks |
|---|---|
| Blood circulation improves and the heart has less work to do to pump blood. | Allergy to the dye. |
| It may be possible to delay or avoid valve replacement surgery. | Occurrence of infectious conditions. |
| You can recover faster than with open heart surgery. | Bleeding. |
| It doesn't leave a big scar on the body. | Damage to a blood vessel or heart. |
| The risk of complications is low. | A leak from the valve. |
| The pain is very mild. | Then the valve narrows again. |
| Heartbeat abnormalities. | |
| Heart attack or stroke (very rare) |
What happens after treatment?
When the treatment is finished, you will be transferred to a recovery area. A bandage will be placed where the catheter was inserted.
- If the catheter was inserted through the groin, you will need to keep your leg straight for several hours. You will usually need to stay in bed for two to six hours.
- You will be told to drink plenty of water . This will help flush out the dye that was put into your body through your urine.
- If you need to urinate while in bed, you will need to use a special device (urinal/bedpan) to do so.
- After a few hours you will be able to get up and walk.
- Most people are able to go home the next day .
How long does it take to recover?
This depends on several factors, such as your general health and heart condition.
- You should avoid strenuous activities such as work and swimming for about five to seven days .
- Most people can return to work in about a week . However, if your job requires physical exertion, your doctor may advise you to rest for a little longer.
- It may take about 8 weeks to get back to your normal life.
- You will be asked to come back for a check-up in about 3-6 months after treatment. After that, you should usually see the doctor once a year.
What time should I call the doctor?
When you go home after treatment, pay close attention to your body. If you experience any of the following symptoms, do not delay and contact your doctor immediately.
| Emergency symptoms to watch out for | |
|---|---|
| - Chest pain | - Feeling cold and having a fever |
| - Fainting / Syncope | - Fluid or bleeding from the insertion site |
| - Nausea or vomiting | - Increasing pain or swelling |
| - Weight gain of more than 1.5 kg (3 lbs) in one day (this may be a sign of fluid retention) | |
When it comes to heart surgery, it's normal to feel a little nervous, even if it's not an open surgery. Valvuloplasty is a great way to delay the need for a new valve. But it's not a one-size-fits-all treatment. If you have any questions about the balloon procedure, don't hesitate to ask your doctor.
Take-Home Message
- Valvuloplasty is a simple, non-invasive procedure that widens a narrowed heart valve using a balloon.
- This is not about installing a new valve, but rather repairing the existing valve.
- The main advantages are faster recovery, less pain, and less scarring than open heart surgery.
- If you experience symptoms such as chest pain, fever, or excessive swelling after treatment, notify your doctor immediately.
- Talk openly with your cardiologist about whether this treatment is right for you and what its benefits and risks are.
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