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Atrial and Mitral Balloon Valvuloplasty

Balloon valvuloplasty is a cardiac intervention to open up stiff heart valves (e.g., aortic or mitral) using a catheter with a balloon on the tip. This is a less invasive procedure because it is done by inserting a catheter into the blood vessel from the groin through the skin, surgical valve replacement.

The heart is a four-chamber blood-pumping organ in the chest cavity. Blood flows from one chamber to another through valves. The following are the four-valve classifications:

  • Tricuspid valve: present between the right atrium and ventricle

  • Pulmonary valve: present between the right ventricle and pulmonary article

  • Mitral valve: a bicuspid valve present between the left atrium and ventricle

  • Aortic valve: present between the left ventricle and ascending aorta

Any inflammation or infection of the valve or a congenital heart defect causes the valves to stiffen. This hinders blood flow to your body.

Why choose Presbyterian for your atrial and mitral balloon valvuloplasty?

Presbyterian Heart and Vascular Care has a skilled vascular care team who can provide a wide range of services from diagnosis to treatment. Their surgeons are trained in many different techniques and procedures, many of which can provide you with a shorter recovery period and less hospital time.

Who is eligible for an atrial and mitral balloon valvuloplasty?

If your heart valves become damaged or diseased, they may not work properly. Valvuloplasty may be a good option for you. Not all conditions in which a heart valve becomes stiff are treatable with valvuloplasty.

What conditions can be treated with an atrial and mitral balloon valvuloplasty?

Conditions that may cause heart valve problems are valvular stenosis (stiffened valve) and valvular regurgitation (leaky valve).

When valves become stiff, the heart muscle must work harder to pump the blood through. Stiff valves may be caused by infection (such as rheumatic fever or staphylococcus infections), birth defects, and aging. If one or more valves become leaky, blood leaks backward, and less blood is pumped in the proper direction.

Heart valve disease may cause the following symptoms:

  • Dizziness.

  • Chest pain.

  • Palpitations.

  • Trouble breathing.

  • Rapid weight gain due to fluid retention.

  • Edema (swelling) of the feet, ankles, or abdomen.

There may be other reasons for your doctor to recommend a valvuloplasty.

How do I prepare for an atrial and mitral balloon valvuloplasty?

  • Tell your doctor if you have ever reacted to any contrast dye or are allergic to iodine.

  • You will need to fast for a certain period before the procedure. Your doctor will tell you how long to fast, usually overnight.

  • Tell your doctor of all medicines and herbal supplements that you are taking. You may need to stop some of these medicines before the procedure.

  • Your doctor may request a blood test before the procedure to determine how long it takes your blood to clot. Other blood tests may be done as well.

  • Tell your doctor if you have a pacemaker.

What should I expect during my atrial and mitral balloon valvuloplasty?

Generally, a valvuloplasty follows this process:

  1. Remove any jewelry or other objects that may interfere with the procedure.

  2. Change into a hospital gown and empty your bladder before the procedure.

  3. A healthcare professional will start an intravenous (IV) line in your hand or arm to inject medicine or give IV fluids if needed.

  4. A healthcare professional will connect you to an electrocardiogram (EKG) to monitor and record the heart's electrical activity. Your vital signs (heart rate, blood pressure, breathing rate, and oxygenation level) will be monitored.

  5. You will get a sedative medicine in your IV before the procedure to help you relax. However, you will likely remain awake during the procedure.

  6. A local anesthetic will be injected into the skin at the insertion site. You may feel some stinging at the site for a few seconds after the local anesthetic is injected.

  7. Once the local anesthetic has taken effect, your doctor will insert a sheath, or introducer, into the blood vessel. Your doctor will insert the valvuloplasty catheter through the sheath into the blood vessel and to the heart.

  8. Once the catheter is in place, your doctor will inject contrast dye through the catheter into the valve to look at the area.

  9. Once the balloon is in place and inflated, you may notice some dizziness or even brief chest discomfort. This should subside when the balloon is deflated. However, if you notice any severe discomfort or pain, tell your doctor.

  10. Your doctor may inflate and deflate the balloon several times to open the valve.

  11. Once the valve is opened sufficiently, your doctor will remove the catheter.

  12. If your doctor uses a closure device, they will apply a sterile dressing to the site. If manual pressure is used, the doctor will pressure the insertion site to form a clot. Once the bleeding has stopped, a very tight bandage will be placed on the site.

  13. Your doctor may decide not to remove the sheath, or introducer, from the insertion site for about 4 to 6 hours. This allows the effects of blood-thinning medicine to wear off. You will need to lie flat during this time.

After the specified period of bed rest, you may get out of bed. The nurse will help you the first time you get up and may check your blood pressure. You will most likely spend the night in the hospital after your procedure.

How do I care for myself after my atrial and mitral balloon valvuloplasty?

Your doctor may advise you not to participate in any strenuous activities for a while. Your doctor will tell you when you can return to normal activities.

Report any of the following to your doctor:

  • Fever or chills.

  • Decreased urination.

  • Swelling of your arms, legs, or abdomen.

  • Weight gain of over three pounds in one day.

  • Increased pain, redness, swelling, or bleeding, or other drainage from the insertion site.

  • Coolness, numbness or tingling, or other changes in the arm or leg.

  • Nausea or vomiting, chest pain or pressure, profuse sweating, dizziness, or fainting.