Opening Narrowed Valves for Congenital Heart Disease

Overview

If a congenital heart disease (CHD) defect involves the narrowing (stenosis) of one of the four valves in the heart (aortic, tricuspid, mitral, pulmonary), the heart can have difficulty passing blood through it. This can cause excessive strain on the heart. In many situations, a narrow valve can be opened using an interventional procedure called a valvuloplasty, which uses thin tubes (called catheters) that are inserted in a blood vessel to deliver treatments.

Valvuloplasty is performed in a cardiac catheterization lab using X-rays and contrast dye that’s injected intravenously. The procedure involves the following process:

1. A suitable blood vessel in the legs, arms, or neck is entered through a small puncture site in the skin, and catheters and special thin wires are used to cross the valve.
2. An X-ray picture is taken, and the size of the valve is measured, along with the nearby structures. A special catheter that has a specifically sized balloon on the tip is passed over a wire through the blood vessel to the heart.
3. The balloon is inflated inside the valve to stretch it open. Additional balloons of larger sizes may be required to achieve the desired result.
4. The success of the procedure is measured again and another picture is usually taken using the X-ray machine.
5. The catheter and wire are then removed from the body.

The results of the valvuloplasty procedure should be known immediately. In some cases, this procedure may have to be repeated in patients.