Heart valve repair is a surgical technique used to fix defects in heart valves in valvular heart diseases, and provides an alternative to valve replacement. Without further specification, it refers to native heart valve repair, rather than repair of an artificial heart valve.

Balloon valvuloplasty is a cardiac intervention to open up a stenotic or stiffed heart valves (e.g., aortic or mitral) using a catheter with a balloon on the tip. It is also known as balloon valvotomy. It is a less invasive procedure because it is done by inserting a catheter into the blood vessel from groin percutaneously rather than valve replacement with cardiothoracic surgical or other open methods. Balloon valvulotomy has several types, depending upon which heart valve is involved for example:

• Percutaneous balloon tricuspid valvuloplasty
• Percutaneous balloon pulmonary valvuloplasty
• Percutaneous balloon mitral valvuloplasty
• Percutaneous balloon aortic valvuloplasty

PROCEDURE

Balloon valvotomy is a non-surgical procedure performed in the cardiac catheterization laboratory by a cardiologist and a specialized team of nurses and technicians.

Long, slender tubes called catheters are first placed into blood vessels in the groin and guided into the chambers of the heart. The cardiologist then creates a tiny hole in the wall between the upper two chambers of the heart. This hole provides an opening for the cardiologist to access the left atrium with a special catheter that has a balloon at the tip.

The catheter is positioned so the balloon tip is directly inside the narrowed valve. The balloon is inflated and deflated several times to widen the valve opening. Once the cardiologist has determined that the opening of the valve has been widened enough, the balloon is deflated and removed.

During the procedure, the cardiologist may perform an echocardiogram (ultrasound of the heart) to get a better picture of the mitral valve.

Balloon valvuloplasty is a less invasive than open-heart valve replacement, but it is not an alternative to valve replacements.

Studies comparing ballon tricuspid valvuloplasty to surgical tricuspid valve replacement are not available, so in most of the cases, tricuspid valve surgery is preferred. However, in high-risk surgical cases or with moderate to severe valvular regurgitation associated with tricuspid stenosis, balloon tricuspid valvuloplasty can be performed.

CLINICAL SIGNIFICANCE

Pulmonary stenosis is a common congenital heart disease characterized by the right ventricular outflow obstruction. The clinical significance in treating pulmonary stenosis in children mainly depends on the severity of obstruction. Mild pulmonary stenosis (gradient

The outcome of clinical trials on the clinical significance of percutaneous balloon mitral valvuloplasty compared to open and closed surgical commissurotomy was that percutaneous mitral balloon valvuloplasty was good or better than surgery in patients who were candidates for valvotomy.