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Valvuloplasty for Mitral Valve Stenosis

Treatment Overview

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 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 it allows more blood to flow from the left atrium into the left ventricle.

Why It Is Done

Valvuloplasty might be recommended if you have severe stenosis and the shape of your mitral valve looks like it can be repaired with this procedure. Your doctor will also check a few other things to see 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.footnote 1

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How Well It Works

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. This also helps relieve symptoms of lung congestion.

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

Risks

Valvuloplasty is catheter-based, not surgical. It has a lower risk of complications and death than an open-heart surgery such as a mitral valve repair 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 this procedure tend to have lower complication rates.footnote 2

After the procedure

Complications that happen after a valvuloplasty include:

  • Mitral valve regurgitation. This might happen in 2 to 10 people out of 100.footnote 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 valvuloplasty. Or you might have valve replacement surgery.

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.

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