Valvuloplasty

What is Valvuloplasty?

Valvuloplasty is a procedure in which a small balloon is inserted and inflated to stretch and open a narrowed (stenosed) heart valve.

Where can I get Valvuloplasty?

Country	Cost with MedSolution
India	$4,600 - single valve  (inquire)
India	$5,500 - double valve  (inquire)

Cost of procedure performed in the US: $50,000 (single valve)

All prices are in US dollars and include the cost of the procedure and minimum hospital stay. Estimates and minimum hospital stay will vary depending upon individual needs and requirements.

Why is Valvuloplasty performed?

Valves are doors or gates that are present in the heart. Depending on their location, they can be aortic, pulmonary, mitral, and tricuspid valves. These valves control the flow of blood to and from the heart. When these valves become narrow (stenosis) due to hardening and calcium deposits, Valvuloplasty is performed to enlarge the narrowed opening and facilitate the flow of blood through them.

Who is an ideal candidate for Valvuloplasty?

Valvuloplasty is used for selective patients who have mitral valve stenosis or pulmonary valve stenosis and cannot undergo a Open Heart Surgery or Beating Heart Surgery (major surgery) for Heart Valve Replacement. Valvuloplasty is also a procedure of choice in older or debilitated patients with aortic stenosis who are considered high risk for above mentioned major surgical procedures. Valvuloplasty is also indicated in children with congenital aortic stenosis, until the child is old enough to have Heart Valve Replacement surgery.

What is the pre-operative period like before the Valvuloplasty?

Valvuloplasty is performed as an outpatient procedure. You will be instructed to avoid eating or drinking anything for 6 - 8 hours before Valvuloplasty procedure. A mild sedative will be injected to help you relax during the Valvuloplasty procedure. Your groin area will be shaved and cleansed with an anti-septic.

What does the procedure of Valvuloplasty involve?

Valvuloplasty is performed in Cardiac Catheterization laboratory or cath. lab. in a hospital. The procedure of Valvuloplasty may take up to four hours. A local anesthetic is injected in your groin at the site where the catheter will be inserted. Guided by a video camera and x-rays, the cardiologist carefully inserts and threads a catheter through your artery or vein depending on where the problem lies. Once this catheter is in place, a balloon tipped catheter is slowly threaded through the first catheter; the deflated balloon is repeatedly inflated to open the valve leaflets apart. Once the valvular opening has been widened enough, the balloon tipped catheter is removed while the first catheter is left in place in case the procedure needs to be repeated.

What to expect during the recovery period following Valvuloplasty?

Following Valvuloplasty, you will be sent to the recovery room where your vital signs will be monitored. If you experience pain, then pain medication will be given, the catheter insertion site will be covered with a sand bag to prevent bleeding. Fluids will be administered to help flush out the dye. ECG will be performed to monitor your heart’s activity. The entire hospital stay may last from 1 - 3 days depending on your general condition.

What is the outcome of Valvuloplasty?

The procedure of Valvuloplasty has been considered to be fairly safe. Valvuloplasty has a success rate of 80 - 90% with minimum chances of post-operative complications and very low incidence of valve leakage. Although Valvuloplasty has been performed since the 1950’s, refined techniques and materials have improved the outcome of this procedure.

B . R . A . N . D . of Valvuloplasty

Benefits of Valvuloplasty

• Valvuloplasty is used to bridge the time gap before Heart Valve Replacement surgery can be scheduled i.e. in very ill patients. Sometimes it possible to open your narrowed valve and leave it open for a long period of time without resorting to Open Heart Surgery. The mortality rate following Valvuloplasty is extremely low. In case of mitral stenosis, Valvuloplasty is the treatment of choice if your heart valves are not calcified.

Risks of Valvuloplasty

• Distortion of the shape of the valve - resulting in leakage (incompetence) or back flow due to incomplete closure (regurgitation)
• Embolism - May result from breaking of small pieces of valve tissue or calcium deposits.
• Irregular heart beat (arrhythmia)
• Bleeding
• Clot (hematoma) formation
• Heart attack
• Puncture through the heart

Alternatives to Valvuloplasty

• Heart Valve Replacement surgery – Mechanical replacement of heart valves
• Valve Repair surgery:
  • Commissurotomy - Fused valve leaflets are separated to widen the valve opening.
  • Decalcification - Calcium deposits are removed to allow the leaflets to be more flexible and close properly.
  • Annulus support - If the valve annulus is too wide, it may be re-shaped or tightened by stitches or sewing a ring structure to the annulus. The ring may be made of tissue or synthetic material
  • Patched leaflets - The surgeon may patch any leaflets with tears or holes with tissue patches.

Now or Never

• With improvement in surgery techniques and improved diagnostic techniques, there could not be a better timing for surgical intervention. In the procedure of Valvuloplasty, the normal anatomy and tissue of the valve is preserved to allow the heart to return to its original function soon after Valvuloplasty. During the procedure of Valvuloplasty, your surgeon can open fused valve leaflets, remove calcium deposits, repair the valve leaflets and attach a ring to support and tighten the enlarged opening.

Decision to have Valvuloplasty

• With improved techniques, Valvuloplasty is considered to be a well tested and successful approach to relieve signs and symptoms of Valvular Heart Disease. In consultation with your surgeon, to have a Valvuloplasty is not a difficult decision to make.