Balloon Valvotomy For Mitral Valve Repair

by Penny Reaves

Posted on Thursday 15th of September 2011

Your heart's four valves (pulmonic, tricuspid, aortic, and mitral) help regulate the flow of blood as it moves between the atria, ventricles, and lungs. These valves are comprised of leaflets that open and close based on the contractions of the individual chambers. For example, your mitral valve (MV) regulates blood flow between the left atrium and left ventricle. When the atrium contracts, the leaflets (or flaps) open to allow blood to flow into the ventricle. When all of the blood has left the atrium, the flaps close to prevent backflow.

One of the disorders that can affect the MV is a condition called stenosis. This article will describe the disorder and explain some of the strategies employed to address it. In some cases, medication is sufficient. However, when drugs are unable to reduce the symptoms, a procedure called balloon valvotomy may be appropriate.

Mitral Stenosis Explained

A stenotic mitral valve is one that is narrowed to the point of limiting blood flow between the left atrium and left ventricle. This narrowing is due to the two leaflets having become stiff or hard. Most patients who have a stenotic MV suffered rheumatic fever when they were young. The fever caused infection near the valve, which triggered an attack from their immune system. This attack, in turn, caused the leaflets to stiffen or harden.

Because blood is prevented from flowing freely, it remains within the atrium. This causes blood to back up into the lungs, which can eventually lead to heart failure, atrial fibrillation, blood clots, and congestion. Patients who suffer from a stenotic MV often experience dizziness, chest pain, breathing difficulties, and swelling within the feet.

Noninvasive Treatment: Medications

If the patient's symptoms are mild, doctors will normally recommend medications to help regulate them. These might include diuretics to help control fluid buildup in the lungs. Anticoagulants may be administered to reduce the blood's clotting ability. If the patient is undergoing surgery, antibiotics might be prescribed to help prevent the onset and spread of infection.

It's worth emphasizing that drug therapy will not cure stenosis. Medications merely help to control symptoms. Resolving a stenotic mitral valve requires a more invasive approach.

Overview Of Balloon Valvotomy

Balloon valvotomy is one of the most common ways to treat mitral stenosis. It is a nonsurgical technique that uses a catheter equipped with a tiny balloon on its tip. The catheter is inserted in the groin and guided through a blood vessel toward the heart. It enters the heart's right atrium. The doctor will make a tiny hole in the septum (the wall that separates the heart's left and right sides) and thread the catheter through it toward the mitral valve.

Once the balloon is positioned between the leaflets, the doctor will inflate and deflate it multiple times. This gradually widens the gap between them. After the doctor is satisfied the MV is wide enough, the balloon-equipped catheter is withdrawn. The insertion site is closed and bandaged, and the patient is moved into a recovery unit.

Postoperative Recovery

To prevent bleeding, the patient is required to lie on his or her back for several hours. An echocardiogram is taken either that day or the following morning in order to provide an image of the newly-widened mitral valve. This image allows the doctor to determine whether the procedure was successful (i.e. the MV is sufficiently wide to allow blood flow).

In some cases, anticoagulants and other drugs are prescribed to the patient prior to his or her being released from the hospital. After release, recovery at home is short; the person can usually return to work within two or three days.

Balloon valvotomy for stenotic mitral valve repair is minimally invasive. The procedure offers an alternative approach to replacing the MV or performing surgery. If you suffer from stenosis, ask your doctor whether this technique is an option.

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