by What are heart valves?
Heart valves are located within the heart and help ensure that blood flows through the heart in one direction only. The four valves of the heart are the mitral valve, tricuspid valve, aortic valve and pulmonary valve. These valves open and close with each heartbeat to allow blood to flow smoothly and efficiently through the heart.
What is valvular heart disease?
Valvular heart disease occurs when one or more of the heart valves do not function properly, either leaking or blocking blood flow. The two main types of valvular heart disease are stenosis, which refers to the narrowing of a heart valve that obstructs blood flow, and regurgitation, which occurs when a heart valve does not close tightly and allowsbackward flow of blood. Untreated valvular heart disease can eventually lead to heart failure.
What is valvuloplasty?
Valvuloplasty is a procedure used to treat some valvular heart conditions without open-heart surgery. It involves the use of a Cardiac Valvulotome – a small catheter-based device inserted through an artery or vein – to repair a diseased heart valve to improve its function. During valvuloplasty, the cardiac valvulotome is used to dilate or decompress the narrowed or stiffened valve to allow better opening and closing. This restores more normal blood flow through the heart.
Types of valvuloplasty procedures
There are different valvuloplasty procedures depending on which heart valve needs treatment:
– Mitral balloon valvuloplasty: Used to treat mitral stenosis, this procedure involves threading a balloon catheter into the heart and inflating it inside the narrowed mitral valve to widen it.
– Aortic balloon valvuloplasty: For aortic stenosis, a cardiac valvulotome with a balloon is guided up to the aortic valve and inflated to force the valve open.
– Pulmonary balloon valvuloplasty: Similar technique is applied to dilate a narrowed pulmonary valve causing pulmonary stenosis.
– Tricuspid balloon valvuloplasty: Inflating a balloon inside the defective tricuspid valve helps in tricuspid stenosis.
Advantages of valvuloplasty over surgery
Valvuloplasty offers some advantages compared to open-heart surgery to replace or repair a heart valve:
– Less invasive procedure without requiring open-heart surgery or median sternotomy incision.
– Shorter hospital stay and faster recovery time.
– Lower risk of complications from heart-lung bypass machine used in surgery.
– May be preferred for high-risk patients who are too ill to undergo open-heart surgery.
– Can be repeated if stenosis recurs.
Cardiac valvulotome technology
Historically, standard cardiac valvulotomes used for valvuloplasty procedures consisted of a simple dilation balloon. Over time, valvulotome technology has advanced with the development of more sophisticated cutting balloon devices.
One such device is the Flexcut valvulotome which features a cutting balloon that can precisely score or cut tissue and commissures in the heart valve. This controlled cutting helps optimize the results of balloon dilation by allowing for a larger final valve area to be achieved.
Other innovative valvulotomes incorporate various cutting elements like helical blades or reciprocating wires mounted on the balloon surface. These mechanical cutting modalities facilitate a more controlled and targeted incision of valve tissue compared to simple balloon dilation alone.
The advancements in cardiac valvulotome design have helped improve outcomes of valvuloplasty procedures. More aggressive and complete tissue scoring or cutting translates to better immediate post-procedure valve enlargement and longer-term durability of valvuloplasty treatment effect.
Overall, valvuloplasty using modern cardiac valvulotomes provides an important minimally invasive option for select patients with valvular heart disease. Continued research and innovation is further enhancing this catheter-based approach as an alternative to open-heart surgery, especially for high-risk or inoperable patients.
Potential complications of valvuloplasty
Like any medical procedure, valvuloplasty carries some risks and possible complications, though the risks are generally lower than valve replacement surgery. Potential complications include:
– Failure of the procedure – The valve may not open up adequately or the condition may recur. This happens in 5-10% of cases.
– Tear in the heart muscle or chamber – This occurs in 1-2% of valvuloplasties and may require emergency surgery.
– Bleeding at the catheter insertion site – Typically minor but transfusion is needed in less than 1% of cases.
– Irregular heartbeat (arrhythmia) – Most resolve on their own but prolonged arrhythmias occur in about 2% cases.
– Blood clots – Small clots may form during balloon inflation and potentially cause a stroke or heart attack. However, risk is less than 1%.
– Damage to heart valves – The valve tissue can tear or a part may break off during the procedure in less than 1% of valvuloplasties.
– Heart attack – Very rare complication occurring in less than 0.5% of valvuloplasty cases.
– Allergic reaction to dye used for X-ray guidance – Most are mild but severe reactions are rare.
Close monitoring and medical supervision help address most complications early should they occur. Overall, valvuloplasty remains a lower risk choice for eligible candidates needing valvular intervention but who are not suitable for open-heart surgery.
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1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
