Valvuloplasty

Valvuloplasty is a procedure to reshape, repair, or widen a diseased heart valve without replacing it. The term encompasses both surgical and catheter-based (transcatheter) techniques, depending on the valve affected and the patient’s circumstances.

Balloon valvuloplasty is the most common catheter-based form. A thin tube (catheter) is threaded through a blood vessel to the narrowed (stenotic) valve, and a balloon at the tip is inflated to stretch the valve opening wider and improve blood flow. This technique is most often used for mitral stenosis (a narrowed mitral valve, usually caused by rheumatic heart disease) and, in selected patients, pulmonary stenosis in adults or aortic stenosis when other options are not suitable.

Surgical valvuloplasty (valve repair) involves directly remodelling the valve leaflets, commissures, or supporting structures using sutures, rings, or other devices. Mitral valve repair is preferred over replacement where anatomically feasible, as it preserves the native valve, avoids the need for lifelong anticoagulation, and has better long-term outcomes. Tricuspid valve repair is also commonly performed surgically.

The decision between valvuloplasty, valve repair, and valve replacement depends on the valve’s anatomy, the severity of dysfunction, the presence of other conditions, and the patient’s surgical risk. For patients too high-risk for surgery, transcatheter valve replacement procedures (such as TAVI for aortic stenosis, or MitraClip for mitral regurgitation) have expanded available treatment options. See also: Transcatheter Intervention, Interventional Procedures.