Procedure for Balloon Valvuloplasty for Aortic Valve Stenosis

Balloon Valvuloplasty is synonymously known as valvulotomy or valvotomy. Aortic balloon valvuloplasty surgery is done to open your aortic valves; which facilitates easy blood flow through the heart. The aortic valve is the door between the left ventricle and the aorta.

This procedure is usually done in a condition called aortic valve stenosis (stenosis=narrowing). Aortic Valve Stenosis is caused by the structural deformities: bicuspid aortic valve, in this case the valve has only two flaps instead of the three.

Indications of Balloon Valvuloplasty

Percutaneous Balloon Valvuloplasty is indicated in children, teenage, and even in the younger generation (who are in their 20’s) suffering from aortic stenosis due to CHD (congenital heart defects) like a bicuspid aortic valve.

In the older generation, stenosis could be a result of the progressive buildup of calcium on the walls of the valves.

Pre-Operative Care

• An informed consent is taken.
• One needs to give information about any allergies to medicines.
• An intracath is placed in the vein.
• Necessary tests like chest x-ray, blood tests, etc are done.
• A dye could be administered during the procedure for aiding the visualizing of arteries, its branches, chambers of the heart, and the valves.

Balloon Valvuloplasty Procedure

In Balloon Valvuloplasty procedure, local anaesthesia with a sedative is administered to help the patient relax. A thin flexible tube/catheter is inserted in the artery and moved inside the heart. When this tube reaches the narrowed aortic valve, a balloon at the end of the tube is inflated. The balloon widens the narrowed valve opening.

Post-Operative Care

1) Bed Rest

Usually bed rest is advised for 6 - 8 hours post the surgery. The patient is advised not to move the legs around.

2) Ice packs

are given to help in decreasing the swelling and pain and to help in preventing tissue damage.

3) Pressure stockings/inflatable boots

Patient is advised to use these post the procedure; as these help in improving the blood flow and prevent clots.

4) Medicines

The following medication is usually given to the patient:

• Medicines for anxiety could be given to lower the anxiousness and help one calm down and relax.
• Painkillers

Risks Involved in Balloon Valvuloplasty

Since Aortic valve replacement has substantial post-surgery complications with severe comorbidities, percutaneous balloon aortic valvotomy,which is also known as balloon aortic valvuloplasty is done. As this is a less invasive procedure for treating severe cases of aortic stenosis.

There is low risk for severe complications observed in children, teens, and young adults. Severe complications are seen in 1 - 2 in 10 older patients. These include complications like:

• Stroke
• Heart attack
• Aortic valve regurgitation

There could be complications associated with the catheter, they are as follows:

• Pain
• Swelling at the catheter insertion site
• Tenderness
• Bleeding

• Superficial Thrombophlebitis/Irritation of the vein
• Problems in urinating

 

Post Discharge Care

One needs to monitor the surgical site for the following:

• Bleeding
• Unusual pain
• Swelling
• Abnormal discoloration
• Temperature change

The patient is advised not to indulge in the strenuous activities till the physician advises them to do so.

The patients should immediately contact the doctor in case they experience the following symptoms:

From the insertion site
• Fever with chills/Chills
• Increased pain
• Redness
• Swelling from the insertion site
• Bleeding
• Drainage

In the affected extremity

• Numbness in the affected extremity
• Tingling

• Chest pain/pressure
• Nausea/vomiting
• Profuse sweating
• Dizziness
• Fainting

Length of Stay in Hospital

The patient is usually in the hospital for 4 days.