Balloon Aortic Valvuloplasty

What is Balloon Valvuloplasty?

Balloon Valvuloplasty

Balloon valvuloplasty a process used to open the aortic valve by using a balloon catheter. Balloon valvuloplasty is primarily used to treat patients who develop aortic stenosis, which is caused by calcification or scarring of the valve leaflets themselves. A balloon catheter is inserted into the blood vessel that feeds the heart and into the artery that feeds the affected valve. The balloon is inflated to deploy pressurized air that pushes apart valves, widening them so more blood can flow through.

Types Of Balloons Valvuloplasty

The two main types of balloons valvuoplasty are:

  • Balloon mitral valvuloplasty is a method used to treat patients suffering from mitral valve stenosis, who have been diagnosed with high-risk aortic stenosis. It is also known as balloon mitral commissurotomy, or balloon mitral valvotomy. It is a safe procedure as well as a blind procedure and is associated with various complications.
  • Balloon aortic valvuloplasty, also known as balloon aortic valvotomy, is a procedure that widens the valve opening so blood can flow easily through the heart. It is often used to treat high blood pressure in your legs or chest when medicine does not help or if you cannot take medicines because they are not working.

Signs and Symptoms

With Aortic Valve Stenosis, the aortic valve remains narrowed causing the left ventricle to expand and work harder than usual. For several decades, you may not notice any signs. However, if your aortic valve becomes so narrowed that it closes only partly and lets blood flow slowly through - you may begin to have trouble breathing (dyspnea). Symptoms are occasionally caused by exercise once the heart needs to work harder such as

  • Chest pain or pressure (angina)
  • Fainting, Dizziness
  • Easy fatigue
  • Breathlessness
  • Palpitations
  • Oedema swelling of feet

Note: There is also a higher risk of sudden death involved.


There are several causes which can lead to aortic valve sentosis such as:

  • The aortic valve is what separates the heart's left and right ventricles, keeping blood flowing in one direction. As you get older, calcium can develop on the uterus, making it thick and hard. This buildup over time typically does not appear until after age 65.
  • Congenital- centre flaw born with Rheumatic fever or endocarditis. These illnesses can damage the valve.

Indications For Balloon Valvuloplasty

There are various indications which are related to different categories like:

  • Children and young adults: Balloon valvuloplasty can be used successfully for Children, and young adults that have symptoms because of congenital heart flaw e.gbicuspid valve.
  • Pregnant women: Pregnant women that experience aortic valve stenosis symptoms and cannot opt for surgery may be eligible for valvuloplasty.
  • As a stop-gap arrangement: Valvuloplasty is also useful as a stop-gap arrangement until the patient can receive the replacement process.
  • Utilization for palliation: It can used for patients who have severe conditions that cannot be cured.


This disease might come into consideration during a regular medical examination. But certain test can also be required to diagnose valve such as:

  • On Auscultation: When a valve disorder is diagnosed, it is essential to understand what type it could be. The different sounds that are detectable are known as heart murmurs and they are caused by blood flowing through an abnormal valve in your heart.
  • Echocardiogram: An echocardiogram or "echo" uses sound waves to make an image of your heart. It reveals the various constructions of the heart and may demonstrate any abnormalities on your valves. The echocardiogram gives the doctor a better picture of whether problems are present in your heart.
  • Electrocardiogram (ECG)
  • X-ray

Risks Involved

Some of the risks involved during the treatment of balloon valvuloplasty are:

  • Stroke
  • Death
  • Kidney failure
  • Abnormal heart rhythms
  • Bleeding at the catheter insertion site
  • Infection at the catheter insertion site
  • New or worsening valve regurgitation (leakage)
  • Rupture of the valve, requiring open-heart surgery
  • Significant blood loss that may require blood transfusion
  • Blood clot or damage to the blood vessel at the insertion site

Apart, from the above-mentioned other risks can be:

  • If you are pregnant or think you could be, tell your doctor due to risk of injury to the fetus from a valvuloplasty.
  • Tell your doctor if you are allergic or sensitive to medicines, contrast dyes, iodine, or latex. If you have kidney failure or other kidney problems, tell your doctor.
  • Some people may find lying still on the procedure table for the length of the procedure may cause some discomfort or pain. To make your experience as comfortable as possible, we ask that you remain still and avoid moving excessively during the procedure.

Note: No medical procedure is without risk. Discuss any concerns with your doctor before the procedure.

Reason For Treatment

You may need to have surgery if you are having symptoms due to narrowed heart valves, or if your valve disease has progressed to a serious stage. Doctors will examine you and determine if valvuloplasty or another treatment is right for your valve condition. Your doctor may recommend valvuloplasty if: You have severe valve narrowing and are having symptoms. You have narrowing of the mitral valve (mitral valve stenosis), even if you do not have symptoms. You have a narrowed tricuspid or pulmonary valve. You or your child has a narrowed aortic valve (aortic valve stenosis). However, the aortic valve tends to narrow again in adults who have had a valvuloplasty, so the procedure is usually done if you are too sick for surgery or are waiting for a valve replacement.

Cost Of Balloon Valvuloplasty In India

Balloon Aortic Valvuloplasty is a procedure that is used to repair a heart valve. The cost of Balloon Aortic Valve Replacement Procedure in India ranges 3600 USD (approximately 2,56,000 INR (Indian Rupee)) which if for the total of 8 days. The cost thus can very as per the diagnosis, patient's condition, surgeon's experience, hospital facilities, city, etc.

Best Cities and Hospitals In India

Here is the list for some best hospitals for balloon valvuloplasty treatment in India:

  • Artemis Hospital, Gurugram
  • Fortis Escorts Hospital, Delhi
  • Medanta Hospital, Gurugram
  • Aster Hospital, Kerala
  • Max Hospital, New Delhi
  • Apollo Hospital, Delhi
  • Global Hospital, Chennai
  • Asian Heart Institute, Faridabad
  • Narayana Hospital, Bangalore
  • BLK Super Speciality Hospital, New Delhi


An aortic valve is located between the left ventricle and the aorta. The valve ensures blood flows in one direction, which prevents backflow into the heart.

The success rate for the surgery in India is 99%.

The doctor will advise you to follow up by different means such as you may need to stay at a recovery location for 2 hours. You will be changed to a recovery room for observation. Bed rest can change from 2 to 6 hours. You might be given medication for pain or distress. You can resume your normal diet after the process. It is important to keep the insertion site clean and dry.

Before the surgery is initiated, the doctor will provide you with anesthesis then the incision process will be carried forward and in the end the closing of incision will take place.

A valvuloplasty is a procedure that widens heart valves that are narrowed or twisted. A long, thin tube (catheter) is put into an artery in your thigh or arm. X-rays are used to help guide the catheter to the narrowed valve in your heart. The doctor then inflates a balloon on the tip of the catheter, which widens the opening of the valve and separates its flaps.

If you have got mild or moderate aortic valve stenosis, your physician will see you frequently for tracking and monitoring. You may not have surgery before your stenosis is severe. Some young people or pregnant women might need balloon valvuloplasty to expand the valve opening. In case you have severe stenosis, you need a valve replacement - most often with an open-heart operation, but minimally invasive procedures are also available.

The warning signs are fever, increased pain, and redness, swelling or bleeding at the insertion site and chest pain or pressure. Nausea, profuse sweating, dizziness, and decreased urination may also be symptoms. Swelling is often a warning sign that a patient should not use their device anymore because of the underlying infection they may have and the potential risk they may have if they were to continue using it.

Severe stenosis (narrowing of the coronary artery) affects the amount of blood your heart can get to pump. If you have severe stenosis but do not have to undergo treatment, you have a high risk of dying suddenly or developing heart failure.

You will remain overnight at the hospital following having a valvuloplasty to be detected for any issues following the procedure. But it is recommended that patients avoid driving or exercising vigorously for 24 hours after this procedure, as this would raise your blood pressure levels unnecessarily. It is safe to resume normal activities after 24 hours.

Balloon valvuloplasty is an effective treatment option for aortic stenosis in children, but it has limited efficacy in older adults. In many older adults, the valve becomes flaccid (restenosis) in 6 to 12 months following this procedure.

Causes of balloon aortic valvuloplasty

The aortic valve is among the four valves of the heart, between the left ventricle and the aorta, the largest blood vessel in your body. The aortic valve opens and closes in a steady rhythm to circulate oxygen-rich blood into the aorta. However, sometimes the valve might not open and close properly, and because of which the heart muscles have to work harder. Stenosis in simple words is the narrowing of the leaflets or cusps due to thickening or scarring of your valve that lets a small amount of blood flow from the left ventricle to the aorta to reach the body.

A few causes for aortic valve stenosis are:

  • Calcium buildup
  • Heart defect from birth
  • Rheumatic fever

Aortic valve stenosis affects both young and adults. People with mild aortic valve stenosis don't usually feel any symptoms. It takes time for the signs to come to notice and even a weakening heart can be overlooked. For patients with serious cases, some of the symptoms that should be noted are:

  • Shortness of breath
  • Tightness or chest pain
  • Fatigue
  • Feeling dizzy or lightheaded
  • Heart murmur
  • Heart palpitation (pounding heart)

Balloon aortic valvuloplasty is among the few treatments opted for curing aortic valve stenosis instead of surgeries.

The procedure of balloon aortic valvuloplasty

In this procedure, the doctor inserts a guidewire through a small incision into an artery in the thigh. The catheter makes its way to the aortic valve where a balloon catheter is passed through it. When the tip reaches the valve, the balloon is inflated to push open the stiff valve and stretch the leaflets or cusps. Later, the balloon is deflated after which the catheter and guidewire are removed. The valve is left wide open for the blood to flow freely in the body.

Balloon aortic valvuloplasty is considered best for infants and children. As for adults, there are chances that the valve may narrow again and hinder blood flow.


Aortic valve stenosis cannot be prevented but a few steps can be considered to lessen its chances. Some of them goes as follows:

  • Maintaining good dental hygiene
  • Take care of high blood pressure and high cholesterol
  • Look forward to a healthy lifestyle

Benefits of balloon aortic valvuloplasty:

  • Shorter recovery time than other surgeries
  • Delay chances of surgeries for a few years
  • Can show results as good as surgical replacement or repair

Procedure of Valve Replacement Surgery

During an Aortic valve replacement surgery, an incision is made by cutting through the sternum. It is also known as median sternotomy. Following the incision being made, the pericardium is opened and subsequently the patient is placed on a cardiopulmonary bypass machine (heart-lung machine). The machine helps in pumping through the heart while the surgeon replaces the heart valve. Once the patient is on bypass, an incision is made in the aorta and a cross clamp is applied. Thereafter the surgeon removes the diseased aortic valve and replace it with the mechanical one. Once the valve is in place and the aorta has been closed, the patient is taken off from the cardiopulmonary bypass machine. Later, Transesophageal echocardiogram is done to confirm whether the new valve is functioning properly or not.

Benefits of Heart Valve Surgery

Damaged heart valves cause a multitude of symptoms such as breathing difficulties, chest pain, edema and heart palpitations. Post Heart Valve surgery, you get rid of all these problems.

Transesophageal Echocardiography (TEE)

TEE is used in determining whether a patient who has the problem of an abnormal heart rhythm is at a high risk for a stroke or not. This process also tells that whether there is any blood clots in the heart.

Stress Echocardiography

The procedure of Stress Echocardiography makes use of exercise or medication for making the heart work harder than when it is resting, helping in obtaining detailed pictures of the heart and its functioning. It looks into the overall heart functioning, the presence of heart diseases, and the effectiveness of the treatment being followed.

Electrophysiology (EP) Study

EP Study is a specialized process that is undertaken by a trained cardiac specialist, who is called the Electrophysiologist. During this process, one or more thin, flexible wires, which are known as catheters, are put into a blood vessel, later guiding into the heart. Every catheter has got two or more electrodes for measuring the electrical signals to heart while they are travelling from one chamber to the other.

This study diagnoses cardiac rhythm abnormality, for the determination of the best treatment, and also to determine the place where therapy should be done.

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