Aortic Balloon Valvuloplasty

What you should know

What is aortic balloon valvuloplasty?

Aortic balloon valvuloplasty (VAL-vu-loh-plas-tee) 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 (A-tree-uh). The two lower chambers are called ventricles (VEN-trik-ulls). 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.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

• There are always risks during aortic balloon valvuloplasty. You may bleed more than usual, get an infection, or have trouble breathing. The artery where the catheter was put may be damaged. The procedure may cause air bubbles, or pieces of calcium from the valve to be in your blood. These could cause a stroke or a heart attack. The other valves or muscles in your heart could be damaged. Your kidneys may stop working. You could have problems with your heartbeat.
  
  
• You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.
  
  
• Even after this procedure, your aortic valve may grow narrow again over time. If this happens, you may need to have this procedure done again or have heart surgery. Your shortness of breath, dizziness, passing out, and chest pain could get worse if you do not have the procedure. Your heart could get larger until it has problems pumping. Fluid could build up in your lungs, and your heart could begin to fail. In heart failure, you will not be able to send the right amount of blood to your body. You could have problems with your heartbeat or you could have a heart attack and die. Call your caregiver if you are worried or have questions about your procedure, medicine or care.

Getting Ready

The week before the procedure:

• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you take any herbs, food supplements, or over-the-counter medicines. Tell your caregiver if you have allergies.
  
  
• Ask your caregiver if you need to stop taking aspirin, or any other prescribed or over-the-counter (OTC) medicine before surgery.
  
  
• Ask your caregiver if you need to take antibiotics before the procedure. This is medicine that fights infection.
  
  
• You may need blood tests before your procedure. Talk to your caregiver about these or other tests you may need. Write down the date, time and location for each test.

The night before the procedure:

• Ask caregivers about directions for eating and drinking.
  
  
• If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your surgery. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before surgery. You may need to check your blood sugar more often before and after having surgery.

The day of the procedure:

• Write down the correct date, time, and location of your surgery.
  
  
• Ask your caregiver before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring a list of your medicines or the pill bottles with you to the hospital.
  
  
• Do not wear contact lenses the day of your procedure. You may wear your glasses.
  
  
• An anesthesiologist may talk to you before the procedure. This is the caregiver who gives you medicine before and during the procedure. This medicine will make you not feel or remember the procedure.
  
  
• You or a close family member may be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do aortic balloon valvuloplasty. The form also explains what may happen during the procedure, and your choices. Be sure all your questions have been answered before you sign this form.

Treatment

What will happen:

• You may be given medicine in your IV to help you relax or make you drowsy. A caregiver will clean the skin on your groin with soap. Your groin is the area where the top of your leg meets your abdomen. Sterile sheets will be put over you to keep the procedure area clean. You will be given a shot of local anesthesia medicine in your groin. It is used to numb (take away feeling from) the area. This will make you more comfortable, but you may still feel pressure or pushing during the procedure.
  
  
• A sheath (long hollow tube) is put through your skin and into the artery (blood vessel) inside your groin. The sheath allows caregivers to insert different catheters (tubes) into the artery during the procedure. A catheter with a balloon on the tip is threaded through the sheath and into your heart. When the end of the catheter is in the aortic valve, the balloon is filled with liquid. The filled balloon forces the valve cusps to open so blood can flow more freely through the valve.

After the procedure:

You are taken to the recovery room or an intensive care unit (ICU). Caregivers will watch you very closely. A bandage is used to cover the area where the catheter went in. This bandage keeps the area clean and dry to prevent infection. A caregiver may remove the bandage shortly after the procedure to check for bleeding or bruising. Do not get out of bed until your caregiver says it is OK. Your family may be allowed to visit you in the ICU for a short visit several times a day.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot come to your appointment on time.
  
  
• You have a fever. Your procedure may need to be done later when you are well.
  
  
• The problems for which you are having the procedure get worse.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.