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Most people are born with four heart valves. However, some children with congenital heart defects may be born with less functioning valves. Sometimes valves are too narrow or stenotic. A valvuloplasty is a procedure that open a heart valve that is blocked or too narrow. It can also be called valve dilatation or valvotomy. A balloon valvuloplasty uses a balloon on the end of the catheter to perform the valvuloplasty.
The board-certified and fellowship-trained pediatric heart specialists at Norton Children’s Heart Institute, affiliated with the UofL School of Medicine, may recommend a balloon valvuloplasty if your child’s heart valve does not allow blood to flow freely through the valve.
The procedure takes place in the pediatric catheterization lab. Your child will be sedated (asleep) with medicine given by a specially trained pediatric cardiac anesthesiologist at Norton Children’s Hospital.
Your child’s doctor will insert a special catheter — a long, thin tube — into a blood vessel, usually in the leg. Your child will have a small incision where the catheter is inserted.
The doctor threads the catheter through blood vessels until it reaches the heart valve. Once it’s in the precise location, the physician inflates a tiny balloon on the end of the catheter. The balloon widens the narrowed opening in the valve. Sometimes a second, larger balloon will be used to open it more. The doctor then deflates the balloon and removes it and the catheter.
Norton Children’s Heart Institute, affiliated with the UofL School of Medicine, is the leading provider of pediatric heart care in Louisville and Southern Indiana.
Norton Children’s has a network of outreach diagnostic and treatment services conveniently located throughout Kentucky and Southern Indiana.
Many pulmonary valves that are candidates for a valvuloplasty are narrow because parts of the valve are stuck together. This type of valve stenosis responds well to being gently opened with a balloon.
Some valves, such as those that are thickened, shortened or notched, do not improve enough with the balloon procedure. For those, surgery may be needed. Interventional cardiologists often will try the less invasive balloon valvuloplasty before considering open heart surgery.
Sometimes the pulmonary valve becomes leaky after a procedure to widen it.
This condition, called valve incompetence, usually is mild. It can occur after both a balloon valvuloplasty or a more invasive surgical valvuloplasty.
The aortic valve separates blood flow from the heart’s left ventricle to the aorta. When it is too narrow, or stenotic, the heart has to work harder to pass blood through the valve. A narrow aortic valve can lead to increased pressure in the heart and heart failure.
The goal of aortic valve dilation is to make the narrowing just wide enough to reduce the pressure in the heart to safe levels, without causing a significant leak in the valve, which can be a complication from any valvuloplasty.
The interventional cardiologist tries to choose a balloon that is small enough to almost get rid of all the narrowing. Then, surgery can be avoided. In about 3% of cases, the valve becomes very leaky, even when the right-sized balloon is used. If this happens, your child may need surgery to repair the valve.