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Valvuloplasty for Mitral Valve Stenosis

Treatment Overview

Valvuloplasty is a treatment for mitral valve stenosis. It is a procedure that widens the mitral valve so that blood flows more easily through the heart. It's also called a balloon commissurotomy or valvotomy.

It's a minimally invasive procedure. You may get medicine that relaxes you or puts you in a light sleep. You won't feel pain when the catheter is put in the blood vessel. A doctor uses a thin flexible tube (catheter) that is inserted through an artery in the groin and threaded into the heart.

When the tube reaches the narrowed mitral valve, a balloon device located on the tip of the catheter is quickly inflated. The narrowed or fused mitral valve leaflets are separated and stretched open as the balloon presses against them. This process increases the size of the mitral valve opening. And it allows more blood to flow from the left atrium into the left ventricle.

Why It Is Done

Valvuloplasty might be recommended if you have severe stenosis and the mitral valve looks like it can be repaired with this procedure. You and your doctor may talk about a few other things to help decide if the procedure is right for you. These things include your overall health and whether you have symptoms.footnote 1

Valvuloplasty is not a good option if you have blood clots in the left atrium, a lot of calcium buildup of the mitral valve, or moderate to severe mitral valve regurgitation.footnote 1

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How Well It Works

A valvuloplasty doesn't cure the condition or make the valve normal. It helps the valve function normally to let blood flow through the heart. The improved blood flow relieves symptoms. Blood pressure inside the left atrium decreases.

Risks

During the procedure

Risks during the procedure aren't common. But problems can include injury to the heart and stroke.

Problems caused by the catheter may include:

  • Pain, swelling, and tenderness at the catheter insertion site.
  • Irritation of the blood vessel by the catheter. This can often be treated with warm compresses.
  • Bleeding at the catheter site.
  • A bruise where the catheter was inserted. This usually goes away in a few days.

After the procedure

Complications that happen after a valvuloplasty include:

  • Mitral valve regurgitation. The valve might be damaged so that it doesn't close normally and allows blood to leak backward in the heart.
  • Restenosis. The valve can become narrow again. You may choose to have another valvuloplasty or valve replacement surgery.

References

Citations

  1. Otto CM, et al. (2020). 2020 ACC/AHA guideline for the management of patients with valvular heart disease. Circulation, published online December 17, 2020. DOI: 10.1161/CIR.0000000000000923. Accessed December 17, 2020.

Credits

Current as of: December 2, 2020

Author: Healthwise Staff
Medical Review:
Rakesh K. Pai MD, FACC - Cardiology, Electrophysiology
Martin J. Gabica MD - Family Medicine
Adam Husney MD - Family Medicine
Michael P. Pignone MD, MPH, FACP - Internal Medicine

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