Our heart is like four rooms in a house. There are doors between these rooms that allow blood to flow back and forth. We call these "Heart Valves". Sometimes these doors do not open properly and become narrow. Then the heart has to work very hard to pump blood. Today we are talking about a treatment method that uses something like a balloon to widen a narrowed valve.
What exactly is valvuloplasty?
Simply put, Valvuloplasty is a procedure that widens or enlarges a narrowed heart valve. This is done to stop the blockage in the flow of blood when the heart valve is not working properly.
This is also called `Balloon Valvuloplasty`. The reason for this is that when your doctor performs this treatment, he uses a very thin tube (`Catheter`) with a small balloon attached to the end. This tube is passed into the narrowed valve in your heart and the balloon is inflated. Then the narrowed valve widens, allowing blood to flow more easily again.
Some people also call this `Valvotomy`. This balloon treatment is also called `Open-heart surgery` to widen the valve. But today we are talking about the non-surgical balloon method.
In what cases is this treatment necessary?
Valvuloplasty is a procedure that is performed to widen a heart valve when it is narrowed (stenosis). This procedure can be performed on any of the four valves in our heart. However, it is most commonly performed on the two valves, the Mitral and Aortic.
Sometimes this treatment is also done as a temporary solution. That is, to temporarily improve the functioning of the heart until a new valve can be implanted at a later date. Valvuloplasty is not a heart valve replacement , which is important to remember.
How do you 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 the night before the treatment (fasting).
- If you are taking any medications, such as anticoagulants, stop them as directed by your doctor.
- Leave metal jewelry and removable dentures at home.
When you go to the hospital, the medical team will give you a medicine (`anesthesia`) to help you relax. Most of the time, you will be awake during this treatment, but they will do everything they can to make sure you don't feel any discomfort.
How the treatment works step by step
This treatment is performed by a cardiologist. It usually takes an hour or more. Here are some things that happen during the treatment:
1. A very thin tube (sheath) is inserted through a large blood vessel in your groin, arm, or shoulder.
2. Then, a catheter with an uninflated balloon at the end is passed through the previously inserted tube into the heart.
3. This catheter is guided to the correct location, and a special liquid (contrast dye) is injected while being watched using imaging technology like X-rays.
4. When the catheter reaches the narrowed valve, the balloon is inflated with air. The narrowed valve then widens.
5. Then, the air in the balloon is deflated and the catheter and balloon are removed.
6. Finally, the catheter insertion site is closed with a small stitch or a special type of glue.
Sometimes, if there is a risk of bleeding, the sheath that was originally inserted can be left in place for about six hours.
What are the benefits and risks?
As with any medical treatment, there are benefits as well as risks. It is important to have a clear understanding of both.
| Benefits | Risks |
|---|---|
| Faster recovery than open heart surgery. | Allergy to the dye used. |
| Minimization of large scars. | Infectious conditions. |
| Reduced risk of complications. | Bleeding. |
| Decreased pain. | Damage to a blood vessel or heart chamber. |
| Decreased heart rate. | Valve leak. |
| Being able to delay or avoid valve replacement surgery. | After a while, the valve narrows again. |
| Abnormal heart rhythm patterns (Arrhythmias). | |
| Heart attack or stroke. |
The specific risk factors that affect you depend on your overall health, so be open about this with your doctor and ask any questions you may have.
Recovery time after treatment
After the treatment, you will be taken to a recovery area. A bandage will be placed over the catheter insertion site.
Time spent in the hospital
If the catheter was inserted through the groin, you will not be allowed to bend your leg for several hours. You will need to stay in bed for two to six hours. You will need to drink plenty of fluids to help the dye that was used leave your body quickly. If you need to urinate during this time, you will need to use a special device (urinal/bedpan). After a few hours, you will be able to get up and walk. Most people can go home the next day.
After going home
Recovery time depends on things like your general health.
- You should avoid strenuous activity and swimming for five to seven days.
- Most people can return to work in about a week, but if your job requires physical exertion, you may need to wait a little longer.
- It may take about 8 weeks to get back to your normal life.
- There will be a follow-up 3-6 months after treatment. After that, you should see the doctor once a year.
When to call the doctor immediately
After returning home, if you develop any of the following symptoms, you should call your doctor immediately . In some cases, you may need to go to the Emergency Department (ETU) of the nearest hospital.
- Chest pain
- Chills or fever
- Dizziness or fainting (`Syncope`)
- Fluid or bleeding from the catheter insertion site
- Nausea or vomiting
- If the pain or swelling is getting worse
- If your body weight increases by more than 1.5 kg (3 lbs) in a day
When it comes to heart surgery, it's normal to feel a little nervous, even if it's not an open surgery. Valvuloplasty can help you postpone heart valve replacement surgery. But it's not a one-size-fits-all treatment. Your doctor will evaluate your condition and decide what's best for you.
Take-Home Message
- Valvuloplasty is a relatively simple procedure that widens a narrowed heart valve using a balloon.
- This is a less painful and quicker recovery method than open heart surgery.
- As with all treatments, there are some risks, so discuss them carefully with your doctor before treatment.
- Follow your doctor's instructions exactly after treatment. If you experience any warning signs, notify your doctor immediately.
- This is a long-term solution for some valves, and in other cases, it may be a temporary solution before a major surgery in the future.
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