Balloon valvuloplasties

Chunky Monkey

Was talking to someone about the differences between cardiology and CT surgery the other day and this came up. So I decided to do a search on it (admittedly not a very extensive one) and came up with articles that were either too technical or too vague.

So far my understanding of it is that a deflated balloon on the end of a wire is inserted through the femerol artery to the stiff (stenotic?) heart valve, it's blown up to stretch out the valve and then removed. My question is: how does the valve stay stretched after the balloon is removed? And does stenosis (or is it sclerosis?) not cause the valve flaps to be stiff as well meaning they can't move effectively or is there some sort of chemical on the balloon that helps dissolve the plaque or is it something completely different from plaque that cause the valves to stiffen?

Or is it only a very temporary solution?

tallaght01

Now, I'm no cardiothoracic surgeon....but...I've had afew babies go for this procedure.

It's usually done for a congenital narrowing of the aortic valves, called aortic stenosis.

If you look at a digram of the heart, you'll see that blood from the left ventricle is pumped around the body via the aortic valves.

So, when the aortic valve is narrow, it's much harder to push blood past it. This puts a lot of strain on the heart, especially if you're a baby. So, the heart may start to fail.

So....the cardiac surgeons go in with a deflated balloon, and when they have confirmed that it's in the right place by x-ray, they inflate the balloon.

Now, this will usually keep the valve open to an extent, but it usually doesn't mean an immediate return to normality. It reduces the pressure on the left ventricle by about 70%. That's usually enough to sort you out, though.

In adults, and I could be talking bollocks here, I think they still do it sometimes, but only as a stop-gap. I think the adult valves are a lot harder to mould back into shape. So, it can be used with some success in adults I believe, although, if you're well enough to cope with open heart surgery, I think that gives better results.

Like I said, I'm no cardiac curgeon, so feel free to correct any of the above that's just a figment of my imagination, guys

Chunky Monkey

Thanks for the reply

When you say open heart surgery do you mean a full replacement or physically stretching it out? It's the flap thing I don't get. I mean they're the same tissues right (? have to go back over my biology), so do they get affected in the same way (ie stiffened and can't move effectively or is widening enough)? Or has plaque nothing to do with it and this procedure is only used when the stenosis is congenital (or whatever else causes stenosis apart from plaque)?

Sorry I know I'm being lazy, I'll look it up

Vorsprung

I think what T01 means by open heart surgery is a valve replacement, so you put the patient on cardiac bypass, then basically cut the heart open, whip out the old stenosed valve and put in a new one.

Aortic stenosis can also be due to calcium build-up and rheumatic heart disease, and generally a valve is the best option. I think T01's right when he says it's a stop gap option, generally they'd want to do a replacement ASAP.