Valvuloplasty for Aortic Valve Stenosis: Before Your Surgery

Balloon valvuloplasty, showing location of the balloon in the heart and the difference between the aortic valve before valvuloplasty and after the procedure

What is valvuloplasty?

Valvuloplasty is a procedure that widens a heart valve that is narrow. When you have a condition called aortic valve stenosis, the valve between your heart and the large blood vessel that carries blood to the body (aorta) is narrow. That forces the heart to pump harder to get enough blood through the valve.

The procedure to widen the valve is also called valvulotomy or valvotomy. It can help the valve work better and improve blood flow through the valve. If you are having symptoms such as chest pain, shortness of breath, or passing out (syncope), this procedure may help you feel better. The procedure is often done before valve replacement surgery.

During this procedure, the doctor puts a thin, flexible tube called a catheter into a blood vessel in your upper leg (groin). The doctor moves the catheter through that blood vessel and into your heart. The doctor puts a dye into the tube. This dye makes your heart show up on a screen so that the doctor can see the aortic valve.

The catheter has a small balloon at the tip. When the tube reaches the narrow heart valve, the balloon is inflated and deflated. Your doctor might do this a few times. The balloon widens the valve opening. Then your doctor removes the balloon and tube from your body.

A cardiac ultrasound test is usually done after, and sometimes during, the procedure.

You likely will stay overnight in the hospital after this procedure.

Your groin may have a bruise and feel sore for a day or two. You can do light activities around the house. But don't do anything strenuous for several days.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before the procedure?

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

Understand exactly what procedure is planned, along with the risks, benefits, and other options.
Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
If you take aspirin or some other blood thinner, be sure to talk to your doctor. He or she will tell you if you should stop taking it before your procedure. Make sure that you understand exactly what your doctor wants you to do.
Your doctor will tell you which medicines to take or stop before your procedure. You may need to stop taking certain medicines a week or more before the procedure. So talk to your doctor as soon as you can.
If you have an advance care plan, let your doctor know. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of the procedure?

Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be cancelled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
Follow your doctor's instructions about when to bathe or shower before your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
Do not shave the surgical site yourself.
Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

Bring a picture ID.
You will be kept comfortable and safe by your anesthesia provider. You may get medicine that relaxes you or puts you in a light sleep. The area being worked on will be numb.
The procedure will take a few hours.
After the procedure, pressure will be applied to the area where the catheter was put into your blood vessel. Then you may have a bandage or a compression device at the catheter insertion site. You might also have stitches there. This will prevent bleeding.
Nurses will check your heart rate and blood pressure. The nurse also will check the catheter site for bleeding.
You will need to lie still and keep your leg straight for several hours. The nurse may put a weighted bag on your leg to help you keep it still.

Going home

You will be given more specific instructions about recovering from your procedure. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.
Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.