Balloon valvuloplasty (valvotomy)

A valvuloplasty (also called a valvotomy) is a minimally invasive structural heart disease treatment to open a narrowed heart valve. Narrowing of heart valves (valve stenosis) can restrict blood flow and cause symptoms such as chest pain or shortness of breath.

In a valvuloplasty, an interventional cardiologist uses a hollow, flexible tube (catheter) to insert a balloon into the narrowed heart valve. When the balloon is in position, the cardiologist inflates it to widen the valve and increase blood flow.

Other names for valvuloplasty include:

• Valvotomy
• Balloon valvuloplasty
• Balloon valvotomy

Balloon valvuloplasty is an inpatient procedure that takes about an hour. You receive anesthesia to keep you calm and comfortable. The team includes an interventional cardiologist, an interventional echocardiographic, and an anesthesia specialist working together to perform a valvuloplasty.

When it’s time for the procedure, the team connects you to an electrocardiogram machine that monitors your heart’s electrical activity. You also are connected to machines that record your heart rate, breathing, oxygen levels, and blood pressure.

During a balloon valvuloplasty, an interventional cardiologist:

1. Places a hollow plastic tube called a sheath through a blood vessel in your groin
2. Inserts a catheter with a balloon on the tip through the sheath
3. Guides the catheter to your heart by watching X-ray and echocardiographic images that show your heart’s structures and blood vessels
4. Injects a contrast dye through the catheter that highlights the narrowed heart valve
5. Positions the balloon in your narrowed heart valve. The interventional cardiologist may ask you to hold your breath for several seconds while they position the balloon. They may need to inflate and deflate the balloon a few times to fully open the valve.
6. Inflates the balloon to expand the valve opening
7. Once the valve is open, the interventional cardiologist removes the catheter and balloon

You can expect to stay in the hospital for one night after a valvuloplasty. You’ll need to lie flat for several hours to reduce your risk of bleeding at the catheter insertion site. Your care team will encourage you to drink plenty of water to flush the contrast dye from your system, but you can usually resume your normal diet immediately after the procedure.

Most people experience an immediate improvement in symptoms of valve stenosis, including a decrease in chest pain, fatigue and shortness of breath. It’s normal to have a small bruise near the catheter insertion site. Your care team will give you instructions to watch for signs of complications, such as bleeding, swelling or temperature changes at the catheter insertion site. You’ll likely need to avoid strenuous activities for a few days after balloon valvuloplasty. Depending on your overall health and the underlying diagnosis, you may be able to resume usual activities within several days.

Complications are rare, but can include significant bleeding, arrhythmia, or blood clots. Call your doctor right away if you experience any signs of complications, such as:

• Chest pain or pressure
• Decreased urination
• Fever or chills
• Nausea or vomiting
• Pain, redness, or heat at the catheter insertion site
• Swelling in your legs or abdomen
• Weight gain that exceeds three pounds in one day

Your provider may recommend you complete cardiac rehabilitation after a valvuloplasty. Cardiac rehab can help speed your recovery and strengthen your heart. Our rehabilitation specialists provide education, nutrition counseling, and gentle exercises in an outpatient setting.

The results of a valvuloplasty can last decades, but the procedure doesn’t cure valve stenosis. If your heart valve narrows again, your cardiologist will discuss your options. You may need medication, a second valvuloplasty or a heart valve replacement procedure.

Penn interventional cardiologists are established experts in balloon valvuloplasty techniques. We have decades of published research and continually offer the newest treatments, often before they’re widely available. When you choose us, you benefit from:

• History of innovation: Penn was one of the first medical systems in the nation to offer balloon valvuloplasty for mitral valve stenosis. Our history of innovation positions our cardiologists as some of the most experienced in the nation.
• Targeted treatments: We offer a full range of advanced valvotomy treatment options. We perform balloon valvotomies in our state-of-the-art cardiac catheterization laboratory (cath lab) using the Inoue Balloon™ catheter, a catheter designed specifically to treat mitral valve stenosis.
• Team-based care: A team of interventional cardiologists, interventional echocardiographers, anesthesiologists and nurses cares for you. Our team-based, subspecialized treatment approach leads to precise treatment and better outcomes.