A valvuloplasty may be done as part of your stay in a hospital. Procedures may vary depending on your condition and your provider's practices.
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Remove any jewelry or other objects that may interfere with the procedure. Check with your healthcare provider to see if you may wear your dentures or hearing aids.
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Change into a hospital gown and empty your bladder before the procedure.
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A healthcare provider will start an IV (intravenous) line in your hand or arm to inject medicine or give IV fluids, if needed.
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If there's excessive hair at the catheter insertion site (groin area), it may be shaved off.
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A provider will connect you to an electrocardiogram to keep track of and record the electrical activity of the heart. Your vital signs (heart rate, blood pressure, breathing rate, and oxygenation level) will be tracked during the procedure.
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There will be several monitor screens in the room. These will show your vital signs, the images of the catheter being moved through the body into the heart, and the structures of the heart as your provider injects the dye.
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You'll get a sedative medicine in your IV before the procedure to help you relax. But you'll likely remain awake during the procedure
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A provider will check and mark your pulses below the injection site and compare them to pulses after the procedure.
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A local anesthetic will be injected into the skin at the insertion site. You may feel some stinging at the site for a few seconds after the injection.
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Once the local anesthetic has taken effect, your provider will insert a sheath (introducer) into the blood vessel. This is a plastic tube through which the catheter will be inserted into the blood vessel and advanced into the heart.
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Your provider will insert the valvuloplasty catheter through the sheath into the blood vessel and to the heart.
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Once the catheter is in place, your provider will inject contrast dye through the catheter into the valve to look at the area. You may feel some effects when the contrast dye is injected into the IV line. These effects include a flushing sensation, a salty or metallic taste in the mouth, or a brief headache. These effects usually last for a few moments.
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Heart ultrasound pictures will also be used to help guide the location of the catheter and see how well it's working.
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Tell your provider if you have any difficulty breathing, sweating, numbness, itching, chills, nausea or vomiting, or heart palpitations.
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The provider will watch the contrast dye injection on a monitor. They may ask you to take a deep breath and hold it for a few seconds. If the valvuloplasty procedure is being done on the aortic valve, your provider may use a temporary pacemaker to make your heart beat faster and lower your blood pressure. You can feel dizzy and confused after the pacemaker has been turned on and off.
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Once the balloon is in place and has been inflated, you may notice some dizziness or brief chest discomfort. This should decrease or go away when the balloon is deflated. But tell your provider if you have any severe discomfort or pain, such as chest pain, neck or jaw pain, back pain, arm pain, shortness of breath, or breathing difficulty.
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Your provider may inflate and deflate the balloon several times to open the valve.
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Once the valve is opened sufficiently, your provider will remove the catheter. They may close the catheter insertion site with a closure device that uses collagen to seal the opening in the artery, by the use of sutures (stitches), or by applying manual pressure over the area to keep the blood vessel from bleeding. Your provider will decide which method is appropriate for your condition.
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If your provider uses a closure device, they'll apply a sterile dressing to the site. If manual pressure is used, the provider or an assistant will hold pressure on the insertion site so that a clot will form. Once the bleeding has stopped, a very tight bandage will be placed on the site.
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Your provider may decide not to remove the introducer from the insertion site for about 4 to 6 hours. This allows the effects of blood-thinning medicine to wear off. You'll need to lie flat during this time. If you become uncomfortable in this position, your nurse may give you medicine to make you more comfortable. Your provider might also give a reversal medicine for the blood thinner to reduce the risk of bleeding and allow for the sheath to be removed from the artery site.
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Next, you'll be taken to the recovery area. NOTE: If the insertion was in the groin, you won't be allowed to bend your leg for a few hours. To help you remember to keep your leg straight, the knee of the affected leg may be covered with a sheet and the ends tucked under the mattress on both sides of the bed to form a type of loose restraint.