A balloon valvotomy 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
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An important consideration when having a balloon
valvotomy is the experience of the doctor. As a general rule, balloon
valvotomies done by a doctor skilled in the procedure usually have better
A balloon valvotomy does not cure the condition or make
the valve normal. It is useful for improving valve function and thereby
reducing the symptoms associated with mitral valve stenosis.
balloon valvotomy may also be used to treat people who have mitral valve stenosis
but do not yet have symptoms (asymptomatic) if they have:
A higher risk of dangerous blood clots
(thromboembolism). This includes people with an irregular heart rhythm called
atrial fibrillation as well as those who have had a
blood clot before.
Mitral valves that are still in fairly good
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.
People with signs of blood clots
in the left atrium, widespread calcification of the mitral valve structures, or
moderate to severe
mitral valve regurgitation are not considered good
candidates for a balloon valvotomy. Balloon valvotomy
is not usually used if the mitral valve is severely narrowed.
Overall, 80% to 95% of people who are treated with a balloon valvotomy
have a successful outcome.1 The opening of the mitral
valve usually increases to at least 2.0 cm2. Also, blood pressure inside the left atrium decreases, which helps relieve
symptoms of lung congestion.
Symptoms may recur after a balloon
valvotomy. Sometimes these symptoms are due to the mitral valve narrowing again
(restenosis). But more often they develop as a result of other heart
conditions, such as problems related to the heart's main pumping chamber (left
mitral valve regurgitation, or an opening in the wall
that separates the upper chambers of the heart (atrial septal defect). People
who develop symptoms shortly after balloon valvotomy (1 to 2 years) are usually
those who had badly damaged valves (calcified, stiff) before the procedure. Also, the more time that passes before symptoms come back, the more likely
it is that they are due to conditions other than restenosis of the mitral
Treatment for any recurrence of symptoms will depend on
their cause. For symptoms caused by restenosis of the mitral valve, a repeat
balloon valvotomy or surgery to repair or replace the valve may be
Bonow RO, et al. (2006) 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, 114(5): e84-e231.
Primary Medical Reviewer
E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer
Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology
February 10, 2010
WebMD Medical Reference from Healthwise
February 10, 2010
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