A balloon valvotomy is the preferred treatment for
mitral valve stenosis. 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
Symptoms of mitral valve stenosis improve almost immediately after a balloon valvotomy.1
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.
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.1
If you don't have symptoms, a
balloon valvotomy may be used if you also have:1
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
mitral valve regurgitation.1
About 80 to 95 out of 100 people who are treated with a balloon valvotomy
have successful outcomes and almost immediate symptom relief.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.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.1
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.1
Complications that happen after a valvotomy include:
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.
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.
To learn more about valve repair and valve replacement options, see:
Complete the special treatment information form (PDF)(What is a PDF document?) to help you understand this treatment.
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):
November 18, 2011
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
& John A. McPherson, MD, FACC, FSCAI - Cardiology
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