What is balloon pulmonary valvuloplasty?
The pulmonary valve is the doorway between the right side of the heart and the lungs. When it is narrowed — pulmonary stenosis — the heart has to push much harder to get blood through, and over time the muscle thickens under the strain.
Balloon valvuloplasty opens the valve from inside. A catheter carrying a deflated balloon is guided across the narrowed valve, the balloon is inflated briefly to stretch the valve open, and then removed. No implant is left behind.
For valvar pulmonary stenosis, this is the treatment of choice at every age.
When it is recommended
When the child has symptoms, or when the pressure difference across the valve measured in the catheterisation laboratory reaches a level indicating significant obstruction. In critical pulmonary stenosis in newborns, it may be needed urgently in the first days of life.
What happens on the day
Under general anaesthesia, a catheter is passed from a vein in the groin to the heart. Pressures are measured on both sides of the valve to confirm the severity. A balloon of carefully chosen size is positioned across the valve and inflated for a few seconds. Pressures are measured again to confirm the improvement.
It usually takes one to two hours.
Recovery
Most children stay one night and go home the next day. Improvement is immediate and measurable on the table. Follow-up echos check that the valve stays open.