Valvotomy

What is it?
Valvotomy is a procedure in which a doctor stretches a heart valve or breaks the obstructions in a valve that don't allow normal flow. Heart valves need to function properly. They direct the flow of blood through the chambers of the heart and to the rest of the body.

When is it used?

The doctor may perform this procedure if you have a scarred valve that blocks the flow of blood to the lungs, to other chambers of the heart, or to the body. This procedure is not the answer for all people with blocked valves. The procedure can be done for aortic, mitral and pulmonary valves.

Examples of alternatives to this procedure are:

• replacing the valve
• repairing the valve with open-chest surgery
• choosing not to have above treatment but continue with drugs while recognizing the risks of this approach.

How is it done?
You will be given a sedative to help you relax. A local anesthetic will be injected into your groin to help keep you from feeling pain.

Then the doctor will put a needle into a groin vein or artery, depending on which heart valve has the problem, and guide a small catheter into the blood vessel. A catheter is a long tube the doctor can use to inject fluid, introduce other catheters and instruments, and measure blood pressure. The doctor will direct the catheter to the problem area of your heart.

The doctor will guide a wire within the small catheter into your heart and through the problem valve. The doctor will remove the first catheter and slide a larger, balloon catheter through the blood vessel, over the wire. The doctor will inject a contrast dye into the balloon so he or she can watch it with x-rays. The doctor will guide the balloon into the problem valve, then inflate the balloon a bit to check, with the x-ray, if it is in the right place. Then the doctor will inflate the balloon so it makes the valve opening larger.

When the balloon is inflated, you may feel some temporary pain. This is not uncommon, but you should tell the doctor. The doctor may repeat this process several times until she or he feels the valve opening is the right size. Then the doctor may replace the large catheter with the smaller one and inject contrast media through the catheter. The doctor may use the smaller catheter to measure the pressure in your blood vessels again and take another x-ray.

The doctor will then remove the catheter and the wire and apply pressure over your groin to control any bleeding.

Why is it done?
Your heart may work normally again. You may avoid having open-chest surgery.

When is it done?
Whenever obstruction is significant.

How to avail it?
Contact appointments at. 682 5000/682 5001.

Preparation
Plan for your care and recovery after the operation. Come to the hospital prepared to stay for a day or two. Before the procedure tell the doctor if you have had any kidney problems or reactions to iodine-containing foods or chemicals, such as seafood or kidney contrast dye.

Follow the instructions provided by your doctor. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

After

You will be taken to a bed in the coronary care unit or the intensive care unit, where you will be carefully watched overnight. Nurses will monitor your heart for at least 24 hours. They will also check your blood pressure and groin sites often for several hours.

While recovering from the procedure, don't bend your legs where the catheters were inserted and don't sit upright in bed or try to get out of bed. If you need to move, the nurse will help you. Being careful with your movements will help prevent bleeding from the catheter sites.

The next morning the IV drips (lines into the vein) may be stopped. After the lab checks show well your blood is clotting, the catheter may be removed. After the catheter is removed, the nurse will put firm pressure on the site for about 20 minutes. A small sandbag will be placed over the puncture site for about 6 hours to help the artery heal.

After the nurse removes the sandbag, he or she will help you walk around the room. Sometime after this, you will be transferred from the coronary care unit or intensive care unit to a regular room. You will be encouraged to walk around the room to prepare for discharge. The entire stay in the hospital may last 1 to 3 days, based on your condition.

Once at home contact the hospital immediately if:

• You develop a fever.
• You become short of breath.
• You have a lot of pain.

Ask your doctor what other guidelines you should follow and when you could come back for a checkup.