The heart's aortic valve (which opens from the left ventricle to the aorta) and mitral valve (which opens into the left ventricle) can sometimes become narrow, impeding the flow of blood. This narrowing, called stenosis, makes the heart work harder to maintain adequate circulation. Aortic and mitral valve stenosis can result from a number of factors, including age-related calcium buildup, rheumatic fever, and congenital defects.
In order to open the valve again, a minimally invasive procedure called a balloon valvuloplasty may be used. In balloon valvuloplasty, a catheter tipped with a deflated balloon is threaded from an entry point in the groin through an artery to the heart, where it is inflated to widen the problematic valve. The balloon is then deflated and removed. Mount Sinai's unparalleled team of interventionalists has vast expertise with this his catheterization procedure, which spares select patients with aortic or mitral stenosis from undergoing open heart surgery.
When Balloon Valvuloplasty is Recommended
Balloon aortic valvuloplasty (BAV) is used in cases of severe aortic stenosis that cause serious symptoms (i.e. difficulty breathing, dizziness, and fatigue), in which surgical replacement of the valve is not an option. Patients who benefit from BAV are typically elderly (with an average age of 85) and suffer from co-morbid conditions, such as lung disease and prior stroke. Many of these patients have limited life expectancy from underlying illness making them unsuitable for more invasive procedures such as percutaneous (TAVR) or surgical valve replacement. The symptom benefit from balloon aortic valvuloplasty typically lasts for six months (ranging from 3 to 12 months); after that it can be repeated again if required.
Balloon mitral valvuloplasty is usually recommended as the preferred procedure for majority of cases of mitral valve stenosis. The suitability of balloon mitral valvuloplasty is decided by an echocardiogram. The symptom benefit after balloon mitral valvuloplasty usually last for 5-7 years and can be repeated again if required.
Balloon Valvuloplasty at Mount Sinai
At the Mount Sinai Cardiac Catheterization Lab, our experts perform 110-120 balloon aortic valvuloplasties and more than 20 balloon mitral valvuloplasties every year for last several years. Our outcomes after balloon valvuloplasty are excellent with less than 1 percent chance of developing stroke or need for urgent open heart surgery.
The balloon valvuloplasty procedure typically involves light intravenous pain medication and local anesthesia where the catheter is inserted into the groin. The procedure lasts for about 30-60 minutes. Patients often stay in the hospital for at least one night following the procedure.