top of page

Mitral Balloon Valvuloplasty

What is Mitral Stenosis (MS)

Mitral stenosis (MS) involves narrowing of the mitral valve, restricting blood flow between the LA and LV. 

 

MS can be caused by rheumatic fever, calcification (typically age related) or may be congenital.

​

When severe can lead to AF, heart failure, pulmonary hypertension and/or stroke.​

​

Symptoms include shortness of breath, palpitations, fatigue or lethargy, 

image.png

MS severity

image.png

Procedure

Equipment

  • 7F venous sheath which is upgraded to delivery sheath size

  • 5F arterial sheath

  • 5F pigtail catheter (LV)

  • transeptal needle and sheath

  • Inoue balloon catheter - varied sizes

Procedure

  • Pt under GA

  • TOE is performed to ensure no clots in the LA and to ensure appropriate placement of balloon.

  • Transeptal puncture is performed from right atrium to the left atrium under TOE and x-ray guidance. The change in the pressure from RA to LA pressure helps confirm successful puncture.

  • Simultaneous pressures are collected from the left atrium (via transeptal puncture) and left ventricule (arterial) (Baseline gradient)

  • Inoue balloon catheter is inserted and positioned, partially and then fully deployed. 

  • Gradient is recalculated.

  • Inflations are continued until desired/satisfied result is achieved.

Pre and post valvuloplasty gradient measurements​

image.png

Balloon inflation across the aortic valve

image.png
bottom of page