The heart's aortic and mitral valves sometimes become narrow, impeding blood flow. This narrowing, called stenosis, makes the heart work harder to maintain adequate circulation. To open the valve again, we at Mount Sinai Heart use a minimally invasive procedure called a balloon valvuloplasty.
During a balloon valvuloplasty we administer light intravenous pain medication and local anesthetic where we insert a catheter. Then we thread the catheter, tipped with a deflated balloon, from an entry point in the groin through an artery to the heart where we inflate the balloon to widen the valve. Once the valve has expanded, we deflate and remove the balloon. Stretching the valve opening generally increases blood flow and reduces symptoms.
The 30- to 60-minute procedure spares patients from having to undergo open heart surgery. Patients often stay in the hospital for at least one night following the procedure.
For the Aortic Valve
Balloon aortic valvuloplasty (BAV) is appropriate when severe aortic stenosis is causing serious symptoms (i.e. difficulty breathing, dizziness, and fatigue) and surgical replacement of the valve is not an option. Typically, patients who benefit from BAV are elderly (with an average age of 85) and suffer from co-morbid conditions, such as lung disease and prior stroke. Many have a limited life expectancy from an underlying illness making them unsuitable for more invasive procedures such as a PCI or surgical valve replacement. BAV tends to alleviate symptoms for 3 to 12 months, lasting about six months on average. We can repeat the procedure if required.
For the Mitral Valve
We use balloon mitral valvuloplasty for most cases of mitral valve stenosis. We use an echocardiogram to determine whether this approach is appropriate for the individual patient. Typically, it is appropriate for patients with are experiencing symptoms, for older patients with aortic valve stenosis who are unable to undergo surgery, and for some patients with pulmonic stenosis. Balloon mitral valvuloplasty usually lasts for five to seven years and, as with BAV, it is safe to repeat the procedure.