Valvuloplasty

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.

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.

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.

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.

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Activity

• Allow your child to slowly become more active. Have your child rest as much as needed. Make sure your child gets enough sleep at night.
• Your child should not ride a bike, play running games or contact sports, or take part in gym class until your doctor says it is okay. This may be for several days. It is okay for your child to walk and play with other children or play with toys.
• Until your doctor says it is okay, your child should not do activities that could cause a blow to the chest, such as wrestling or playing catch with a ball.
• Until the doctor says it is okay, your child should avoid lifting anything that would make your child strain. This may include heavy milk containers, a heavy backpack, or a medium-sized pet.
• Your doctor will tell you when your child can go back to school or day care. Your child will probably have to spend at least 1 day at home.
• For about 1 week, keep your child away from large crowds and people that you know have a cold or the flu. This lowers your child's chance of getting an infection.

Diet

• Your child can eat a normal diet. If your child's stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Have your child drink plenty of fluids (unless your doctor tells you not to).
• You may notice a change in your child's bowel habits right after the procedure. This is common. If your child has not had a bowel movement after a couple of days, call your doctor.

Medicines

• Your doctor will tell you if and when your child can restart any medicines. The doctor will also give you instructions about your child taking any new medicines.
• Be safe with medicines. Have your child take pain medicine exactly as directed.
  • If the doctor gave your child a prescription medicine for pain, give it to your child as prescribed.
  • If your child is not taking a prescription pain medicine, ask the doctor if your child can take an over-the-counter medicine.
• If you think the pain medicine is making your child sick to the stomach:
  • Have your child take the medicine after meals (unless the doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, be sure your child takes them as directed. Your child should not stop taking them just because your child feels better. Your child needs to take the full course of antibiotics.
• If your child takes a blood thinner, be sure to get instructions about how to give this medicine safely. Blood thinners can cause serious bleeding problems.
• Have your child take medicines exactly as prescribed. Call your doctor if you think your child is having a problem with their medicine.

Care of the catheter site

• For the first day or for as long as your doctor recommends, keep a bandage over the spot where the catheter was put in.
• You can put ice or a cold pack on the catheter site for 10 to 20 minutes at a time to help with soreness or swelling. Do this every few hours. Put a thin cloth between the ice and your child's skin.
• Your child can shower 1 to 2 days after the procedure. Avoid soaking the catheter site in water until the area is healed. This includes keeping your child out of bathtubs and swimming pools.
• Watch for bleeding from the site. A small amount of blood on the bandage can be normal.
• If your child is bleeding, have your child lie down and press on the area for 15 minutes to try to make it stop. If the bleeding does not stop, call your child's doctor or seek immediate medical care.