Balloon Valvotomy for Mitral Valve Stenosis
A balloon valvotomy is the preferred treatment for Reference mitral valve stenosis Opens New Window. It is a procedure that widens the mitral valve so that blood flows more easily through the heart.
A balloon valvotomy is 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 allows more blood to flow from the left atrium into the left ventricle.
What To Expect After Treatment
Symptoms of mitral valve stenosis improve almost immediately after a balloon valvotomy.Reference 1
Call your doctor if symptoms return
Symptoms may happen again after a balloon valvotomy. Sometimes these symptoms are due to the mitral valve narrowing again (restenosis). Restenosis might happen 1 to 2 years after treatment. But symptoms can also be caused by other valve, heart, or lung problems, especially when they develop long after the valvotomy procedure.
If symptoms happen again after a valvotomy, tell your doctor. You will be asked about your symptoms and will probably have tests to check your heart valves.
Why It Is Done
If you have symptoms, a balloon valvotomy is the preferred treatment for mitral valve stenosis. It is usually recommended if you also have moderate to severe stenosis and if most of your mitral valve is a normal shape.Reference 1
If you don't have symptoms, a balloon valvotomy may be used if you also have:Reference 1
- Moderate to severe stenosis.
- High blood pressure in the lungs (pulmonary hypertension).
- Mitral valves that are still in fairly good condition.
Your doctor may recommend a balloon valvotomy if you are planning to have another surgery (not on your heart), if you are pregnant, or if you are planning a pregnancy.
Balloon valvotomy 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 Reference mitral valve regurgitation Opens New Window.Reference 1
How Well It Works
About 80 to 95 out of 100 people who are treated with a balloon valvotomy have successful outcomes and almost immediate symptom relief.Reference 1
A balloon valvotomy 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, which also helps relieve symptoms of lung congestion.
Doctors and hospitals that have a lot of experience doing balloon valvotomies tend to have higher success rates.Reference 1
Balloon valvotomy is catheter-based, not surgical, and has a lower risk of complications and death than an open-heart surgery such as a commissurotomy or valve replacement.
After 3 to 7 years, about 35 to 50 out of 100 people need another procedure or surgery.Reference 1
During the procedure. Risks during the procedure aren't common. Complications such as blood clots or tears in the heart happen in about 1 person out of 100. Death from the procedure might happen in 1 or 2 people out of 100. Doctors and hospitals that have a lot of experience doing balloon valvotomies tend to have lower complication rates.Reference 1
After the procedure. Complications that happen after a valvotomy include:
- Reference Mitral valve regurgitation Opens New Window. This might happen in 2 to 10 people out of 100.Reference 1 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 after 10 to 20 years. 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 balloon valvotomy, or you might have valve replacement surgery.
What To Think About
Deciding whether you need treatment for mitral valve stenosis—and if so, when—is a major decision. To make this decision, you and your doctor will consider the severity of your mitral valve stenosis, the possibility that it will get worse, and the risks of surgery.
For more information about valve repair and valve replacement options, see Reference Mitral Valve Stenosis: Repair or Replace the Valve?
Bonow RO, et al. (2008). 2008 Focused update incorporated into the ACC/AHA 2006 Guidelines 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 (Writing committee to revise the 1998 Guidelines for the management of patients with valvular heart disease). Circulation, 118(15): e523–e661.
|By:||Reference Healthwise Staff||Last Revised: November 18, 2011|
|Medical Review:||Reference Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Reference John A. McPherson, MD, FACC, FSCAI - Cardiology