Blood passes through a valve before leaving each chamber of the heart. There are four valves within your heart. The heart valves make sure blood flows in only one direction through your heart.
The mitral valve is located between the left upper and lower chambers of the heart. It has two leaflets that open and close similar to a double door.
Stenosis means narrowing of an opening, such as a heart valve. Stenosis of the mitral valve limits the forward flow of blood from the left atrium to the left ventricle. This may cause a back-up of blood and fluid in the lungs.
Mitral stenosis most commonly develops many years after a person has had rheumatic fever, although many patients diagnosed with mitral stenosis don't recall ever having the illness.
Many of the symptoms of mitral stenosis, such as shortness of breath and fatigue, result from a back-up of blood in the lungs. Other symptoms of mitral stenosis may include quick weight gain; weakness; dizziness; swelling in the ankles, feet and/or abdomen (edema); and/or heart palpitations (irregular heartbeat).
Mitral stenosis most commonly develops many years after a person has had rheumatic fever, although many patients diagnosed with mitral stenosis don't recall ever having the illness. During rheumatic fever, the valve becomes inflamed. Over time, the leaflets of the inflamed valve stick together and become scarred, rigid and thickened, limiting its ability to open completely.
Valve stenosis can sometimes be treated with medications if the symptoms are mild. When medications do not work to control symptoms, balloon valvotomy or surgical valve repair or replacement is performed.
Balloon valvotomy successfully opens the narrowed valve and improves the overall function of the heart. If balloon valvotomy cannot be performed, surgical valve repair or replacement may be options. Valve repair may be performed to separate fused valve leaflets, sew torn leaflets or reshape parts of the valve. Valve replacement (removing the old valve and replacing it with a mechanical or biological valve) is reserved for valves that are damaged beyond repair.
Balloon valvotomy is used to increase the opening of a narrowed (stenotic) valve. It is used for:
This balloon valvotomy procedure can be performed on the mitral, tricuspid, aortic or pulmonary valves.
Balloon valvotomy is a non-surgical procedure performed in the cardiac catheterization laboratory by a cardiologist and a specialized team of nurses and technicians.
Long, slender tubes called catheters are first placed into blood vessels in the groin and guided into the chambers of the heart. The cardiologist then creates a tiny hole in the wall between the upper two chambers of the heart. This hole provides an opening for the cardiologist to access the left atrium with a special catheter that has a balloon at the tip.
The catheter is positioned so the balloon tip is directly inside the narrowed valve. The balloon is inflated and deflated several times to widen the valve opening. Once the cardiologist has determined that the opening of the valve has been widened enough, the balloon is deflated and removed.
During the procedure, the cardiologist may perform an echocardiogram (ultrasound of the heart) to get a better picture of the mitral valve.
The procedure lasts about 1 hour, but the preparation and recovery time add several hours. Please plan on staying at Cleveland Clinic all day for the procedure and remaining in the hospital overnight. Patients usually go home the day after the balloon valvotomy procedure. When you are able to return home, arrange for a companion to bring you home.
When you go home after the procedure, call your doctor or nurse immediately if you have:
Balloon valvotomy is a procedure that may relieve many of the symptoms of valve disease, but it will not cure valve disease. Some patients may continue to need medications, even after a successful procedure.
After the procedure, you will need to continue seeing your doctor regularly to make sure your heart valves are working properly. Lifestyle factors that can worsen valve disease may also need to be changed. An exercise program may be prescribed to improve your heart health after the procedure.
To protect your heart valves from further damage, tell your doctors, dentist and other health care providers that you have valve disease so antibiotics can be prescribed before you undergo any procedure that may cause bleeding. Also, take good care of your teeth and gums.
New percutaneous, non-surgical procedures to treat mitral regurgitation (leaky valve) are being tested.
Cleveland Clinic has the nation's largest valve treatment program.
Doctors vary in quality due to differences in training and experience; hospitals differ in the number of services available. The more complex your medical problem, the greater these differences in quality become and the more they matter.
Clearly, the doctor and hospital that you choose for complex, specialized medical care will have a direct impact on how well you do. To help you make this choice, please review our Miller Family Heart and Vascular Institute Outcomes.
Patients are evaluated for percutaneous mitral valve treatments by our Interventional Mitral Valve physician team. This multidisciplinary team includes surgeons, cardiologists, and nurses from:
A full evaluation is required to determine if you are a candidate for a percutaneous procedure. For more information on how to be evaluated, please contact our Heart and Vascular Institute Resource Nurses.
See: About Us to learn more about the Sydell and Arnold Miller Family Heart & Vascular Institute.
To obtain a surgical consultation, or if you have additional questions or need more information, click here to contact us, chat online with a nurse or call the Miller Family Heart and Vascular Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.
Diagnostic tests are used to diagnose your valve disease and the most effective treatment method.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 05/03/2019