Aortic valvuloplasty

Aortic valvuloplasty
Other namesBalloon aortic valvotomy
ICD-9-CM35.11
OPS-301 code5-353.0

Aortic valvuloplasty also known as balloon aortic valvotomy is the widening of a stenotic aortic valve using a balloon catheter inside the valve. The balloon is placed into the aortic valve that has become stiff from calcium buildup. The balloon is then inflated in an effort to increase the opening size of the valve and improving blood flow.

According to the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease,[1] balloon valvuloplasty (also referred to as balloon valvotomy) is not indicated for most patients with aortic stenosis. The preferred alternative, if available, is aortic valve replacement. However the guidelines noted specific settings in adults in which balloon valvotomy can be considered:

  • As a "bridge" to surgery in hemodynamically unstable patients who are at high risk for aortic valve replacement.
  • Use for palliation in patients with serious comorbid conditions that prevent performance of aortic valve replacement.

In addition, there are two other settings in which balloon valvotomy has been considered:

  • As a "bridge" to delivery to symptomatic pregnant women.
  • In patients who require urgent noncardiac surgery. However, the ACC/AHA guidelines concluded that most asymptomatic patients with severe AS can undergo urgent noncardiac surgery at relatively low risk with careful intraoperative and postoperative management.

Recent improvements in both balloon technology and procedural technique may lead to a resurgence in the clinical application of balloon valvuloplasty. Valvuloplasty is an important part of the procedure to deploy a percutaneous aortic valve.

History

The first two percutaneous ultrasound-guided fetal balloon valvuloplasties, a type of in utero surgery for severe aortic valve obstruction, were reported in 1991.[2]

See also

References

  1. ↑ "ACC/AHA 2006 Guidelines for the Management of Patients with Valvular Heart Disease (see page e26)" (PDF). American Heart Association. August 1, 2006.
  2. ↑ Kohl, T.; Sharland, G.; Allan, L. D.; Gembruch, U.; Chaoui, R.; Lopes, L. M.; Zielinsky, P.; Huhta, J.; Silverman, N. H. (2000-05-15). "World experience of percutaneous ultrasound-guided balloon valvuloplasty in human fetuses with severe aortic valve obstruction". The American Journal of Cardiology. 85 (10): 1230–1233. doi:10.1016/s0002-9149(00)00733-5. ISSN 0002-9149. PMID 10802006.


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