Aortic valve stenosis is a condition where the aortic valve becomes narrow. This prevents the blood from flowing forward. Thus, resulting in a strain on the heart muscle. In order to push the blood forward and prevent a backflow, the heart muscles become thicker near the narrowed valve. This condition can be congenital or may occur in older people with rheumatoid arthritis or calcium deposits due to aging. In order to treat aortic valve stenosis, doctors recommend balloon valvuloplasty. Let us have a look at this medical procedure in the following paragraphs.
What is Balloon Valvuloplasty?
Also called as balloon valvulotomy, balloon valvotomy or percutaneous balloon valvuloplasty. This is a surgical procedure that helps in opening up a narrowed heart valve. It is a minimal invasive procedure and does not require an open heart surgery.
The cardiologist uses the help of an echocardiography and X-ray images to guide a thin, flexible catheter through an artery. This catheter reaches the narrowed valve and a balloon fixed at the end of the catheter is inflated. The inflated balloon presses against the hardened tissue and helps open up the narrow valve.
What are the Reasons for Undergoing Balloon Valvuloplasty?
The main cause for undergoing balloon valvuloplasty is the narrowing of the valves in newborn babies or older people. Although the standard procedure for stenosis is open heart surgery or valve replacement, not all people can undergo this surgery. They may be weak or their age does not permit a major operation.
What to Expect During Balloon Valvuloplasty?
There are many questions going through one’s mind when a surgery is suggested. The following information will help you understand the process of valvuloplasty better.
Preparing for the Procedure
The doctor will take your detailed medical history and conduct a physical examination. Certain tests will be conducted by the doctor. He will then explain to you the process and any precautions that you need to take. You will also be advised to avoid eating or drinking at least 6-8 hours before the procedure. Remove any jewelry or piercing on your body. If pregnant or suspect you are pregnant, make sure you inform the doctor beforehand. Let him know if you are allergic to certain medications, latex, tape or anything else. Those with a bleeding disorder should bring this fact to the notice of their doctor.
During the Procedure
You will be admitted to the hospital before the procedure. An intravenous line (IV) will be started in your hand before the procedure. You will be asked to lie on your back on the operation theater. Any excessive hair on the groin or armpit area will be shaved. An ECG monitor will be connected to your chest. This will help the cardiologist monitor the heart activity. Along with this, your vital signs that are, blood pressure, breathing rate, oxygenation level will be monitored.
The cardiologist will inject a dye to observe the heart structures on the many monitors placed in the room. Local anesthetic will be injected. Then, a sheath will be inserted into the blood vessel. Through this sheath or plastic tube, the catheter will be inserted into the artery and guided towards the heart.
In order to monitor the path, the cardiologist will use fluoroscopy to observe the vlavuloplasty catheter advancing towards the heart. Once it reaches its destination, the dye will be inserted through the catheter. This will cause one to feel flushed, have a brief headache or have a metallic or salty taste in mouth for a few moments.
Once the catheter with the balloon is in place, it will be inflated. One may feel a bit dizzy at this point. The balloon will be inflated and deflated a couple of times. If one experiences any severe pain, shortness of breath, jaw or neck pain, back pain, arm pain, they should notify the doctor immediately.
After the valve is sufficiently opened, the catheter will be removed. The insertion site will be sealed with the help of collagen for the artery and sutures. Sterile dressing will be applied to avoid infection at the site of suture. The sheath will remain inside for 4 to 6 hours. This is to help the effects of blood thinners reduce. One will be asked to remain still during this time. You will be soon shifted to a recovery room.
After the Procedure
After the procedure, you will be asked to take bed rest for 2 to 6 hours. Gradually, the effects of anesthesia will wear off and you will feel sensation coming back to your leg or arm. You may feel the need to urinate. In this case, a bedpan will be given, so that you do not move or bend your leg or arm. After the sheath is removed, you will be offered a light meal. You will be asked to drink a lot of water to flush out the dye.
After the specific time of bed rest is complete, the nurse will help you stand. Depending on your health, the doctor will decide onthe discharge date.
You can resume normal activities as per your doctors guidelines. Any bleeding at the site of insertion should be notified to the doctor immediately. In case one experiences, fever, chills, chest pain, nausea, vomiting, sweating, swelling, dizziness, fainting, etc. they need to visit the doctor immediately.
Complications of Balloon Vulvuloplasty
This procedure carries a low risk of serious complications. However, it may cause some problems like stroke, heart attack or aortic valve regurgitation. Other complications include:
- Pain, swelling and tenderness at the site of insertion
- Bleeding at the site of insertion
- Embolism due to clots or pieces of valve breaking off
- Abnormal heart rhythms
- Heart attack
- Heart infection
- Heart puncture
Balloon vulvuloplasty is basically a safe procedure. It helps provide temporary relief to patients with problems of heart blood flow. Speak to your cardiologist in detail, to clear any doubts you may have regarding the procedure.
Written by: Saptakee sengupta
Date last updated: March 18, 2015