Balloon pulmonary valvotomy is a minimally invasive surgical procedure often used to treat patients suffering from an ailment called pulmonary valve stenosis. Balloon pulmonary valvotomy is believed to show good long-term results and is also a relatively safer procedure than other highly invasive procedures that can lead to big complications. The pulmonary valve is present between the right ventricle and the pulmonary artery of the heart. The main function of the valve is to act as a doorway that helps the blood flow from and into the heart.
Pulmonary valve stenosis is a medical illness which occurs when the pulmonary valve does not function properly. In Pulmonary valve stenosis, the valve is not able to open properly to allow the flow of blood. Pulmonary valve stenosis is a very rare disorder and has a huge chance of being present at birth. Pulmonary valve stenosis may not always require treatment, however, in case of severe cases, many people may go for treatments like Balloon pulmonary valvotomy in order to get well.
Presence of Pulmonary valve stenosis is most commonly present during birth, though it may be diagnosed much later. This means that Pulmonary valve stenosis is a congenital condition which develops when the baby is in the womb. There are several risk factors that can lead to this condition. These include:
• Defects in the genes and chromosomes of the child, like the Down Syndrome
• Severe Medication, drug or alcohol abuse during pregnancy.
• Viral infection during the initial months of pregnancy.
• If the mother was having type 1 or type 2 diabetes, it might have interfered with the development of the child's heart.
• Pulmonary valve stenosis appears to run in families and is associated with many genetic syndromes
• Smoking during pregnancy increases the risk of having a child with Pulmonary valve stenosis.
The signs and symptoms of Pulmonary valve stenosis may range from mild to severe and may be observed at birth or a little later as the child grows. People suffering from Pulmonary valve stenosis on a mild scale may notice no symptoms at all. However, during strenuous physical activities, symptoms of Pulmonary valve stenosis may surface, after which the patient is recommended a Balloon pulmonary valvotomy. These include:
• Heart murmur, an abnormal whooshing sound heard using a stethoscope, caused by turbulent blood flow
• Fatigue
• Shortness of breath, especially during exertion
• Chest pain
• Fainting- Loss of consciousness
• Bluish tone to the skin, which may appear due to lack of circulation of blood in the body.
• Prominent and enlarged jugular vein
Pulmonary valve stenosis can lead to sudden death in severe instances, therefore Balloon pulmonary valvotomy is recommended as soon as Pulmonary valve stenosis is diagnosed.
Pulmonary stenosis can cause a condition called heart murmur. A heart murmur may sound like a whooshing, blowing and rasping when the doctor examines your heart through a stethoscope. This is a preliminary test by the doctor to analyze if you may have Pulmonary stenosis.
If the doctor feels that you are showing symptoms of Pulmonary stenosis, he may conduct another set of diagnostic tests to confirm the medical condition.
These include:
• Chest X-ray: To view images of the valve.
• Electrocardiogram (EKG): This test is used to check the thickening of the muscular wall of your right ventricle.
• Echocardiogram: This diagnostic test is carried out to check the shape and structure of the pulmonary valve, the site and how severe the stenosis is.
• MRI and CT scans are also done to confirm Pulmonary stenosis.
• In Balloon valvuloplasty, the doctor gives you anaesthesia to make you sleepy and to numb the site of surgery. The Heart Balloon Surgery procedure usually takes about 2 hours.
• The doctor then makes a small incision in the groin area in order to reach an artery through which a flexible thin tube called catheter is inserted.
• Using X-ray images to obtain the exact location of the catheter, the doctor guides the catheter towards the heart valve where the Pulmonary stenosis is present. will move the tube to the pulmonary valve.
• The healthcare provider will thread a very thin wire through the tube.
• Once the cardiologist gets a fair idea of the arteries, he may then pass a small wire through the catheter. This second catheter follows the already guided wire and has a small balloon hinged to it. Once the balloon reaches the blocked pulmonary valve, the balloon is inflated.
• During this balloon inflation, the valve leaflets stretch so as to make the opening bigger. This opening then restores the normal blood flow.
• Once the valve opens up, the doctor deflates the balloon, closes the incisions with the requires dressings and concludes the Balloon Pulmonary Valvotomy.
The Balloon pulmonary valvotomy is a minimally invasive procedure which does not involve any huge risks or complications. However, due to surgery, some minor risks may pop up. Post Balloon pulmonary valvotomy, you may experience some side effects like:
• Soreness
• Bleeding (rare)
• Infection
• Minor Blood Clots
At a large success rate of Balloon pulmonary valvotomy, symptoms wash away right after balloon valvuloplasty. However, your doctor may prescribe you lifelong medicine, change in lifestyle, and eating habits, all of which are necessary to follow in case you do not want any more complications related to Pulmonary valve stenosis.
KIMS Hospital 
Dr. Aseem R. Srivastava 
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