What is Valvuloplasty?

Valvuloplasty is a procedure to widen one or more heart valves that are too narrow. Heart valves control blood flow between the upper chambers (atria) and lower chambers (ventricles) of the heart. Heart valves can become narrow (stenosis) and stiff due to disease, aging, infection, and other causes. This can cause the valves to not work properly. The goal of this procedure is to repair and improve heart valve function and improve blood flow between the atria and ventricles.

This procedure may involve widening one or more of the following:

• The mitral valve, between the left atrium and left ventricle.
• The tricuspid valve, between the right atrium and right ventricle.
• The aortic valve, between the left ventricle and the main artery that supplies blood to the body (aorta).
• The pulmonary valve, between the right ventricle and the artery that supplies blood to the lungs (pulmonary artery).

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding or blood clots.
• Allergic reactions to medicines or dyes.
• Damage to other structures or organs, such as blood vessels.
• Abnormal heart rhythm (arrhythmia).
• Tearing (rupture) of the valve.
• Heart attack.
• Stroke.
• Leaky valve. This may require emergency surgery.

What happens before the procedure?

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• You may be given antibiotic medicine to help prevent infection.

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

General Instructions

• Do not use any products that contain nicotine or tobacco for as long as possible before your procedure. These include cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be asked to shower with a germ-killing soap.
• You may have an echocardiogram. This test creates ultrasound images of the heart that allow your health care provider to see how the heart valves work while your heart is beating.
• You may have a blood or urine sample taken.
• Plan to have someone take you home from the hospital or clinic.
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

• To lower your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area of the incision (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• A germ-killing solution (antiseptic) will be used to wash the incision area, which is usually the groin. Hair may be removed from this area.
• An incision will be made in one of your legs, usually near your groin area.
• A thin tube (catheter) will be passed into the incision and into a large blood vessel.
• X-ray images (fluoroscopy) will be used to help guide the catheter toward your heart.
• When the catheter reaches the valve that needs to be fixed, dye (contrast dye) may be injected to help your surgeon see the area clearly.
• A catheter with an inflatable tip (balloon-tip catheter) will be guided to the valve that needs to be fixed.
• When the balloon-tip catheter reaches the valve, it will be inflated and deflated. This opens the valve. When the valve is opened wide enough, the catheters will be removed.
• The incision in your groin may be closed with stitches (sutures) and covered with a bandage (dressing).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• You will be on bed rest. You will not be allowed to bend your leg that has the incision.
• You may have to wear compression stockings. These stockings help to prevent blood clots and reduce swelling in your legs.
• Do not drive for 24 hours if you were given a sedative.
• You may have some pain. You will be given pain medicine as needed.

Valvuloplasty, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• A tender lump and bruising in your groin.
• Soreness.

Follow these instructions at home:

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• Do not apply powder or lotion to the area.

Driving

• Do not drive until your health care provider approves.
• Do not drive or use heavy machinery while taking prescription pain medicine.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do not lift anything that is heavier than 10 lb (4.5 kg) until your health care provider says it is safe.

Lifestyle

• Limit alcohol intake to no more than 1 drink a day for nonpregnant women and 2 drinks a day for men. One drink equals 12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not take baths, swim, or use a hot tub until your health care provider approves.
• To prevent or treat constipation while you are taking prescription pain medicine, your health care provider may recommend that you:
  • Drink enough fluid to keep your urine clear or pale yellow.
  • Take over-the-counter or prescription medicines.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.
• Follow instructions from your health care provider about eating or drinking restrictions.
• Wear compression stockings as told by your health care provider. These stockings help to prevent blood clots and reduce swelling in your legs.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever or chills.
• You have more redness, swelling, or pain around your incision.
• You have more fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.
• You have nausea or you feel dizzy.
• You have swelling or pain in your leg.

Get help right away if:

• You develop bleeding from your incision that does not stop.
• You have chest pain.
• You have difficulty breathing.