How long does a mitral valvuloplasty take to perform?
A mitral valuloplasty is a procedure to improve function of the heart's mitral valve.
A mitral balloon valvuloplasty — a procedure to improve the function of the heart's mitral valve — takes about an hour. The procedure requires a few hours for preparation before, and recovery after the procedure. The patient will undergo several blood and imaging tests on the day before and the day of the procedure. The patient is likely to require a day of hospitalization.
How is a mitral valvuloplasty performed?
A cardiologist usually performs a mitral valvuloplasty in a heart catheterization lab. It is a non-surgical procedure performed using local anesthesia and mild sedation.
Preparation
In preparation for the procedure the patient may be required to
- Avoid eating or drinking for eight hours prior
- Check before taking any regular medications
- Inform the doctor
- of any allergies
- if there is a pacemaker implant
- if pregnant
- Empty the bladder and bowel
- Undergo blood tests that include coagulation parameters
- Undergo imaging tests just before or during the procedure, which may include
- Electrocardiography
- Doppler echocardiography
- Transesophageal echocardiography
- Transthoracic echocardiogram
- Intracardiac echocardiography
- Coronary arteriography that involves injecting a dye through a catheter into the coronary arteries to obtain images
Procedure
The anesthesiologist
- Administers painkillers and mild sedation through an IV line.
- Connects the patient to the electrocardiogram to monitor the heart’s electrical impulse.
- Monitors the patient’s vital functions such as
- heart rate,
- blood pressure, and
- oxygen levels.
- May intubate some patients to provide oxygen.
- The cardiologist
- Injects local anesthetic to numb the catheter insertion site in the groin.
- Makes a tiny incision in the skin, punctures the femoral vein and inserts the catheter.
- Advances the catheter gently through the vein up till it goes into the right atrium of the heart, with the guidance of ultrasoundcan images.
- Injects a dye to scan the heart and the coronary blood vessels through continuous X-ray (fluoroscopy) images.
- Inserts the catheter into the left atrium through a tiny hole made in the atrial wall (septum).
- Inserts the catheter into the mitral valve, and inflates and deflates the balloon several times to widen the valve opening.
- Withdraws the catheter back through the vein and out of the puncture site.
- Stops bleeding at the insertion site and applies a bandage.
Post-procedure
The patient
- Is monitored for a few hours in the recovery room.
- Will be able to resume most normal activities within a day or two.
- Must avoid strenuous activities and heavy lifting.
- Will be required to undergo follow-up tests.
- May have to make permanent changes in diet and lifestyle.
How long does a mitral valvuloplasty last?
The effects of a mitral valvuloplasty may last a minimum of about two years. The procedure offers immediate relief from symptoms and improves blood flow, but is not a cure for mitral valve disease, which must be managed with regular checkups, medication and good lifestyle practices.
In otherwise healthy patients, mitral valvuloplasty may postpone mitral valve surgery for up to 10 years. For younger patients in good physical condition, mitral valvuloplasty has better long-term results.
What are the risks and complications of a mitral valvuloplasty?
Mitral valvuloplasty is generally a safe and effective treatment for mitral valve stenosis, especially in patients whose valve is not calcified and who have no other coexisting conditions.
The complications of mitral valvuloplasty include
- Mitral regurgitation
- Injury to the mitral valve leaflets
- Lacerations in the blood vessel and hemorrhage
- Stroke due to blood clot
- Perforation of the heart
- Bleeding in the sheath covering the heart (pericardium)
- Atrial septal defect due to the puncture hole in the septum not closing within a few weeks as it normally should
- Recurrence of stenosis
- Death