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Balloon Valvotomy for Mitral Valve Stenosis

Treatment Overview

A balloon valvotomy 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.

A balloon valvotomy is a minimally invasive procedure. A doctor uses a thin flexible tube (catheter) that is inserted through an artery in the groin or arm 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 allows more blood to flow from the left atrium into the left ventricle.

What To Expect After Treatment

Symptoms of mitral valve stenosis typically improve right away after a balloon valvotomy.

Call your doctor if symptoms return

Symptoms may happen again after a balloon valvotomy. Sometimes these symptoms are due to the mitral valve narrowing again (restenosis). Restenosis might happen 1 to 2 years after treatment. But symptoms can also be caused by other valve, heart, or lung problems, especially when they develop long after the valvotomy procedure.

If symptoms happen again after a valvotomy, tell your doctor. You will be asked about your symptoms and will probably have tests to check your heart valves.

Why It Is Done

A balloon valvotomy might be recommended if you have severe stenosis and the shape of your mitral valve looks like it can be repaired with a valvotomy. Your doctor will also check a few other things to see if a valvotomy is right for you. These things include your overall health and whether you have symptoms.

Balloon valvotomy 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.1

How Well It Works

A balloon valvotomy 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, which also helps relieve symptoms of lung congestion.

Doctors and hospitals that have a lot of experience doing balloon valvotomies tend to have higher success rates.

Risks

Balloon valvotomy is catheter-based, not surgical, and has a lower risk of complications and death than an open-heart surgery such as a commissurotomy or valve replacement.

During the procedure

Risks during the procedure aren't common. Serious complications might happen in 1 to 12 people out of 100. Death from the procedure might happen in 1 to 3 people out of 100. Doctors and hospitals that have a lot of experience doing balloon valvotomies tend to have lower complication rates.2

After the procedure

Complications that happen after a valvotomy include:

  • Mitral valve regurgitation. This might happen in 2 to 10 people out of 100.2 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 require valve replacement surgery.

If your valve has narrowed again, treatment will depend on the condition of the valve. You might have another balloon valvotomy, or you might have valve replacement surgery.

What To Think About

Deciding whether you need treatment for mitral valve stenosis—and if so, when—is a major decision. To make this decision, you and your doctor will consider the severity of your mitral valve stenosis, the possibility that it will get worse, and the risks of surgery.

To learn more about valve repair and valve replacement options, see:

Mitral Valve Stenosis: Repair or Replace the Valve?

Complete the special treatment information form (PDF) (What is a PDF document?) to help you understand this treatment.

References

Citations

  1. Nishimura RA, et al. (2014). 2014 AHA/ACC guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, published online March 3, 2014. DOI: 10.1161/CIR.0000000000000031. Accessed May 1, 2014.
  2. Rodriguez L, Gillinov AM (2007). Mitral valve disease. In EJ Topol, ed., Textbook of Cardiovascular Medicine. Philadelphia: Lippincott Williams and Wilkins.

Other Works Consulted

  • Nishimura RA, et al. (2014). 2014 AHA/ACC guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, published online March 3, 2014. DOI: 10.1161/CIR.0000000000000031. Accessed May 1, 2014.

Credits

ByHealthwise Staff
Primary Medical Reviewer Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Specialist Medical Reviewer John A. McPherson, MD, FACC, FSCAI - Cardiology

Current as ofAugust 8, 2014

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