(Balloon Valvuloplasty)

Procedure Overview

What is valvuloplasty?

Valvuloplasty is performed, in certain circumstances, to open a stenotic (stiff) heart valve. In valvuloplasty, a very small, narrow, hollow tube, or catheter, is advanced from a blood vessel in the groin through the aorta into the heart. Once the catheter is placed in the valve to be opened, a large balloon at the tip of the catheter is inflated until the leaflets (flaps) of the valve are opened. Once the valve has been opened, the balloon is deflated and the catheter is removed.

Other related procedures that may be used to assess and treat the heart include resting and exercise electrocardiogram (ECG or EKG), Holter monitor, signal-averaged ECG, cardiac catheterization, chest x-ray, computed tomography (CT scan) of the chest, coronary artery bypass graft surgery, valve repair/replacement surgery, echocardiography, electrophysiological studies, magnetic resonance imaging (MRI) of the heart, myocardial perfusion scans, radionuclide angiography, and ultrafast CT scan. Please see these procedures for additional information.

Valves of the heart:

To better understand how valvular heart disease affects the heart, a review of basic heart anatomy and valve function follows.

The heart is a pump made of muscle tissue. The heart has four pumping chambers: two upper chambers, called atria, and two lower chambers, called ventricles. The right atrium pumps blood into the right ventricle, which then pumps the blood into the lungs where wastes such as carbon dioxide are given off and oxygen and other nutrients are taken into the blood.

From the lungs, the blood flows back into the left atrium, is pumped into the left ventricle, and then is pumped through the aorta out to the rest of the body and the coronary arteries. When the atria are pumping, the ventricles are relaxed in order to receive the blood from the atria. Once the atria have pumped their entire blood load into the ventricles, they relax while the ventricles pump the blood out to the lungs and to the rest of the body.

In order to keep the blood flowing forward during its journey through the heart, there are valves between each of the heart's pumping chambers:

  • tricuspid valve - located between the right atrium and the right ventricle

  • pulmonary (or pulmonic) valve - located between the right ventricle and the pulmonary artery

  • mitral valve - located between the left atrium and the left ventricle

  • aortic valve - located between the left ventricle and the aorta

If the heart valves become damaged or diseased, they may not function properly. Conditions that may cause dysfunction of heart valves are valvular stenosis and valvular insufficiency (regurgitation). When one (or more) valve(s) becomes stenotic (stiff), the heart muscle must work harder to pump the blood through the valve. Some reasons why heart valves become stenotic include infection (such as rheumatic fever or staphylococcus infections) and aging. If one or more valves become insufficient (leaky), blood leaks backwards, which means that less blood is pumped in the proper direction.

Valvular heart disease may cause the following symptoms:

  • dizziness

  • chest pain

  • breathing difficulties

  • palpitations

  • edema (swelling) of the feet, ankles, or abdomen

  • rapid weight gain due to fluid retention

Reasons for the Procedure

Valvuloplasty is performed in certain situations in order to open a heart valve that has become stiff as a result of disease or the aging process. Not all conditions in which a heart valve becomes stiff are treatable with valvuloplasty.

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

Risks of the Procedure

Possible risks associated with valvuloplasty include, but are not limited to, the following:

  • bleeding at the catheter insertion site

  • blood clot or damage to the blood vessel at the insertion site

  • infection at the catheter insertion site

  • cardiac dysrhythmias/arrhythmias (abnormal heart rhythms)

  • stroke

  • new or worsening valve regurgitation (leakage)

  • rupture of the valve, requiring open-heart surgery