Balloon dilatation of mitral stenosis (valvuloplasty)
Mitral stenosis is a heart valve disease that manifests in the later stages of a person's life due to the involvement of the heart valves of the childhood disease Acute Rheumatic Fever.
Mitral stenosis is a narrowing of one of the four valves in our heart (mitral valve in medical terms), which makes it difficult for blood to pass from one chamber of the heart to the other. In mitral stenosis, there is difficulty in the passage of blood from the left atrium to the left ventricle. Therefore, blood accumulates in the lungs in the form of water (in medical terms, pulmonary edema or congestion and/or pleural effusion). This causes the person to feel short of breath.
What are the treatment options in mitral stenosis?
Treatment options vary depending on the degree of narrowing of the heart valve. While drug treatment may be sufficient in mild stenosis, there are two options for moderate and severe stenosis (valve area less than 1.5 cm2):

Mitral Balloon Valvuloplasty
Open Heart Surgery

Mitral balloon valvuloplasty is performed under local anesthesia and the patient is awake during the procedure. The right or left groin region is anesthetized and the balloon is advanced to the heart through a small hole opened in this area. The stenosis is opened by inflating the balloon in the stenosis area. Thus, in patients - for whom we can find a solution with mitral balloon valvuloplasty - the need to open the chest cage, stop the heart and use a heart-lung machine during surgical practice is eliminated. After the procedure, patients can be kept under observation for one day in the intensive care unit. They can stand up the next day and even the majority of patients can be discharged the next day. It has been shown that when mitral balloon valvuloplasty is performed in suitable patients, the treatment results can be as good as in patients who have undergone cardiac surgery. This procedure is performed in our hospital in suitable patients.

What are the advantages of mitral balloon valvuloplasty?
Since it is performed with local anesthesia, the consciousness of the patient remains open during the procedure. The right or left groin region is anesthetized and the balloon is advanced to the heart through a small hole opened in this area. Thus, the need to open the chest, stop the heart and use a heart-lung machine is eliminated.
After the procedure, patients are kept under observation in the ward instead of the intensive care unit.
Patients can stand up the next day.
Most patients can be discharged the next day.
It has been shown that when mitral balloon treatment is performed in suitable patients, the treatment results can be as good as in patients who have undergone cardiac surgery.
There is no need for continuous use of blood thinners (Coumadin-Warfarin) after the procedure in patients whose valve is opened with a mitral balloon and who do not have rhythm irregularities. However, use of this type of drugs is mandatory for life in patients who have an artificial mechanical valve after cardiac surgery. With balloon mitral valvuloplasty, approximately 90% of the patients' complaints are reduced. This improvement may continue for up to 20 years. Most patients experience relief for at least 5 to 10 years. Mitral balloon treatment can be repeated if necessary. Surgical treatment may be required in patients who are not suitable for mitral balloon treatment for the second time.


Who is not suitable for mitral balloon dilatation?
Those who have excessive calcification of the mitral valve, those who have a clot due to stenosis in their heart (for this reason, it should be made sure in all patients that there is no clot in the heart by performing TEE before the procedure), and cases where there is moderate and severe blood flow back in the mitral valve with mitral stenosis are not suitable for dilatation.
What are the risks of mitral balloon dilatation (valvuloplasty) procedure?
Unfortunately, no procedure is completely risk-free. These risks are related to your general health, the severity of heart disease, and your age. A severe tear may occur in the valve (less than 2% probability) and cardiac surgery may be required to correct the tear. Emergency heart surgery may be required (1% chance).