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About Mitral Stenosis

Mitral stenosis is a blockage of the mitral valve in the heart. The two flaps of the valve (leaflets) have become stuck together, which reduces the blood flow from one heart chamber to another, causing a back-up of fluid into the lungs. This makes you feel short of breath.

About Aortic Stenosis

Aortic stenosis can be a problem as you get older. The aortic valve controls the amount of blood that leaves the heart to be pumped around the body. Sometimes the valve becomes narrow because of disease. This is called aortic stenosis. The blood is no longer able to flow freely from the heart and supply the body. This may result in you experiencing chest pain, shortness of breath or fainting.

Pre-operative Preparation

You will be required to fast for 6 hours prior to the procedure (no food or drink). Your Doctor will advise if you should cease any medication. Take any medication you require in the morning with a small amount of water.

You may require some or all of the following tests prior to the procedure:

  • Echocardiography
  • Coronary Angiography
  • Right Heart Catheter – After an injection of local anaesthetic, a soft balloon catheter is put into the vein in your groin. The tube is passed along until it reaches the heart and then goes up into the blood vessels of the lung. The pressures in the lungs and heart are recorded.

Procedure

A valvuloplasty is a procedure where the valve is widened using a balloon. This will allow the blood to flow more freely.

You will be given a local anaesthetic and sedative to help you relax.

A small incision is made in the groin area and a wire is passed along the blood vessel, up to the heart, until it reaches the aortic valve, or mitral valve, depending on where the blockage lies. The Doctor uses X-ray imaging to see the wire.

Once the wire is in place, a balloon is passed along the wire and into the damaged valve. The balloon is pumped up where the valve is narrowed. This widens the valve, as far as possible. The balloon may be pumped up several times.

At the end of the procedure, the wire and balloon are removed.

Aortic Valvuloplasty

Aortic Valvuloplasty is not able to get rid of all the narrowing. The procedure is done to relieve the symptoms caused by your valve disease, but it is not a long-term cure.

  • This temporary repair can last 6 to 12 months. It is likely your symptoms will return within 1 to 3 years.
  • Depending on your illness, a repeat balloon procedure may be needed.
  • You will only have this procedure if you are not a suitable candidate for heart surgery.

Mitral Valvuloplasty

Mitral Valvuloplasty can give you complete relief of symptoms in over 90% of patients. This improvement can last for up to 20 years. Most patients have relief for at least 5 to 10 years.

Post-operative Care

Patients will generally be discharged from hospital the day after the procedure. Your doctor will review you prior to discharge. A QCG staff member will be in contact with you in the weeks after your procedure to arrange a follow-up appointment in the rooms with your doctor.

Possible Risks and Complications

In recommending this procedure, your doctor has balanced the benefits and risks of performing the procedure against the benefits and risks of not proceeding. Your doctor believes there is a net benefit in going ahead.

There are risks and complications associated with this procedure. They include, but are not limited to the following.

Common Risks & Complications More than 5%
  • Minor bruising at the puncture site.
  • Abnormal heart beat lasting several seconds, which settles by itself.
  • Major bruising or swelling at the puncture site
 
Uncommon risks and complications 1 to 5%
  • A stroke. This can cause long-term disability.
  • Embolism. A blood clot may form and break off from the catheter. This is treated with blood thinning medication.
  • Accidental puncture of the heart. This may need surgery to repair.
 
Rare risks and complications Less than 5%
  • Ongoing abnormal heart rhythm.
  • Surgical repair of the groin/arm puncture site or blood vessel.
  • Loss of kidney function due to the side effects of the X-ray dye.
  • If the catheter is unable to get into the leg vein, the puncture site may be changed to the opposite leg or a different approach may be taken, e.g. catheter goes through the arm or neck.
  • The femoral artery (in the groin) is accidently punctured. This usually requires pressure on the artery. Rarely, this may require surgery to repair.
  • Infection. This will require antibiotics.
  • Heart attack.
  • An allergic reaction to the X-ray dye.
  • A higher lifetime risk from X-ray exposure.
  • Air embolism requiring oxygen to be given.
  • Damage to the nerve in the leg.
  • A hole may accidentally be made in the heart or heart valve, requiring surgical repair.
  • Emergency heart surgery due to complications with this procedure.
  • Skin injury from radiation causing redness of the skin.