Aortic Balloon Valvuloplasty

WHAT YOU SHOULD KNOW:

What is aortic balloon valvuloplasty?

Aortic balloon valvuloplasty is a procedure that is done on the aortic valve. It helps open up the valve so that blood can flow more easily through the heart. This procedure may be done if you do not want or cannot have surgery to treat your aortic stenosis.

Where is the aortic valve?

• Your heart has four chambers or rooms. The two upper chambers are called atria. The two lower chambers are called ventricles. When the heart "beats," the atria pump blood into the ventricles. The ventricles then pump blood out of your heart. The right ventricle pumps blood into the pulmonary artery, and then into the lungs to get oxygen. The left ventricle pumps blood with oxygen into the aorta and out to the body.
  
  
• There are valves (doors) between the chambers that open and close to direct blood flow through the heart. The aortic valve is the door between the left ventricle and the aorta. The aortic valve is made up of three smaller "cusps" attached to the aortic ring. The cusps come from the sides and top of the valve and meet in the middle to "close the door." When the ventricle squeezes to push the blood out, the valve opens and allows blood into the aorta. The valve closes after the blood goes through to prevent it from flowing back into the ventricles.

What is aortic stenosis?

Stenosis means narrow or tight. Because your aortic valve is stenosed, it is unable to open all the way. There are several ways the aortic valve may become stenosed. Most people with aortic stenosis were born with a problem in their aortic valve. The valve may have two cusps instead of three, or the cusps may be deformed and only partly open. As people get older, calcium can build up on the cusps. Calcium build-up may cause the cusps to get thicker and stiffer. Having had rheumatic fever may also cause aortic stenosis.

AFTER YOU LEAVE:

Take your medicine as directed.

Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

• Carry a card in your wallet or purse that tells about your heart problems. List all the medicines that you are taking on the back of the card. This information will help caregivers if you ever have an emergency.
  
  
• Antibiotics: If you are taking antibiotics, take them until they are all gone even if you feel better. Caregivers may tell you to take antibiotics before and after dental work, surgery and some procedures. This is especially important when you have heart valve disease. Antibiotics help to kill any germs that come into your blood and protect your aortic valve from becoming infected. You may be given antibiotics once a month if you had rheumatic fever in the past.
  
  
• Aspirin: This medicine may be given to help thin the blood to keep blood clots from forming. This medicine makes it more likely for you to bleed or bruise.
  
  
• Blood thinners: Blood thinners are medicines that help prevent blood clots from forming. Clots can cause strokes, heart attacks, and death. Blood thinners make it more likely for you to bleed or bruise. If you are taking a blood thinner:
  
  
  • Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin and a soft toothbrush on your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports, such as football.
    
    
  • Be aware of what medicines you take. Many medicines cannot be used when taking medicine to thin your blood. Tell your dentist and other caregivers that you take blood-thinning medicine. Wear or carry medical alert information that says you are taking this medicine.
    
    
  • Take this medicine exactly as your primary healthcare provider tells you. Tell him right away if you forget to take the medicine, or if you take too much. You may need to have regular blood tests while on this medicine. Your primary healthcare provider uses these tests to decide how much medicine is right for you.
    
    
  • Talk to your primary healthcare provider about your diet. This medicine works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and other foods, such as cooked peas and kiwifruit.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Bathing:

You may bathe or shower as soon as you feel well. Carefully wash the skin around your incision (cut) with soap and water. Pat the area dry with a clean towel. Watch the site for any redness, swelling, or drainage. You may have a bruise that travels from your groin incision and down your leg. This will go away in time. However, if you have a bruise that is painful or swollen, call your caregiver immediately.

Drinking liquids:

You may urinate more than usual if dye was used during the procedure. Drink 6 to 8 cups of liquid each day. Follow your caregiver's advice if you must change the amount of liquid you drink. Good liquids to drink are water, juices, and milk. Limit the amount of caffeine you drink, such as coffee, tea, and soda.

Good nutrition for your heart:

Get enough calories, protein, vitamins, and minerals to help prevent poor nutrition and muscle wasting. You may be told to eat foods low in cholesterol or sodium (salt). You also may be told to limit saturated and trans fats. Do eat foods that contain healthy fats, such as walnuts, salmon, and canola and soybean oils. Eat foods that help protect the heart, including plenty of fruits and vegetables, nuts, and sources of fiber. Ask what a healthy weight is for you. Set goals to reach and stay at that weight.

Exercise:

• You may be given an exercise tolerance test after you have recovered from the procedure. An exercise tolerance test helps caregivers see the changes that take place in your heart during exercise. It checks for blockage in the arteries of your heart. An EKG is done while you ride an exercise bike or walk on a treadmill. Caregivers will ask you how you are feeling during the test. They want to know if you have chest pain or trouble breathing. Be sure to tell them how you feel.
  
  
• After the exercise tolerance test, you and your caregiver can plan an exercise program for you. Exercising makes the heart stronger, lowers blood pressure, and keeps you healthy. Start exercising when your caregiver says it is OK. It is best to start slowly and do more as you get stronger.

Pregnancy:

A woman's heart works harder during pregnancy. Talk to your caregiver if you are a woman with aortic stenosis and you want to get pregnant. Whether your heart can stand the extra work of pregnancy depends on the condition of your aortic stenosis. If you do get pregnant, make sure to tell your pregnancy caregiver that you have aortic stenosis. It is also very important to keep all appointments with your heart caregiver during your pregnancy.

Rest:

You may feel like resting more after the procedure. Slowly start to do more each day. Rest when you feel it is needed.

Wellness hints:

• Colds or the flu: Stay away from people who have colds or the flu. Ask your caregiver if you should get shots to keep from getting the flu and pneumonia. Also try to stay away from large groups of people. This decreases your chance of getting sick.
  
  
• Do not smoke: If you smoke, it is never too late to quit. Ask for information about how to stop smoking if you need help.
  
  
• Manage your stress: Stress may slow healing and lead to illness. Learn ways to control stress, such as relaxation, deep breathing, and music. Talk to someone about things that upset you.

For support and information:

You and your family may feel scared, confused, and anxious after the heart procedure. These feelings are normal. Talk about them with your caregiver or with someone close to you. Ask your caregiver about support groups for people with heart disease. Such a group can give you support and information. You may call or write:

• American Heart Association
  7272 Greenville Avenue
  Dallas , TX 75231-4596
  Phone: 1- 800 - 242-8721
  Web Address: http://www.heart.org
  

CONTACT A CAREGIVER IF:

• You have a fever.
  
  
• The skin around your incision is red, more swollen, or has pus coming out.
  
  
• You have chills, a cough, or feel weak and achy.
  
  
• Your skin is itchy, swollen, or has a rash.
  
  
• You have questions or concerns about your procedure or medicine.

SEEK CARE IMMEDIATELY IF:

• Your bandage becomes soaked with blood and the bleeding is not stopping. Apply firm pressure to the puncture site and call your caregiver immediately.
  
  
• You feel that your heartbeat is not regular, too fast, or too slow.
  
  
• You have chest pain or trouble breathing that is getting worse over time.
  
  
• You suddenly feel lightheaded and have trouble breathing.
  
  
• You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.
  
  
• Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  
  
• You have signs of a heart attack:
  
  
  • Chest pain that spreads to your arms, jaw, or back.
    
    
  • Nausea (upset stomach).
    
    
  • You are having trouble breathing.
    
    
  • You are sweating a lot.
    
    
  • This is an emergency. Call 911 or 0 (operator) to get to the nearest hospital or clinic. Do not drive yourself!