Mitral valve expansion by balloon is a non-surgical medical procedure to treat mitral valve stenosis. This procedure helps improve blood flow, reduce symptoms associated with mitral valve stenosis such as fatigue, shortness of breath, and chest discomfort, and improve the patient’s quality of life.
During the mitral valve expansion by balloon procedure, a catheter equipped with a balloon at its tip is inserted through one of the thigh veins. Then the balloon is placed across the narrow mitral valve and inflated. Inflating the balloon leads to opening the narrow mitral valve opening and improving blood flow. This procedure is performed under sedatives and local anesthesia and takes about an hour. Follow the next lines with us to learn more about the mitral valve expansion by balloon procedure and mitral valve symptoms with Professor Dr. Mohamed El-Ghannam, Consultant of Open-Heart Surgery and Minimally Invasive Surgical Intervention.
What is the Mitral Valve Expansion by Balloon Procedure?
Mitral valve expansion by balloon is a minimally invasive medical procedure via catheter to treat mitral valve stenosis without open-heart surgery, where a balloon is passed through the narrow valve and inflated to widen its opening and improve blood flow. It takes about an hour, and its success rate exceeds 95%, and its results may last 10-15 years. It is suitable for patients with a flexible, non-calcified valve without severe regurgitation or a clot in the left atrium.
What is the Mitral Valve Expansion by Balloon Procedure?
Mitral valve expansion by balloon is a medical procedure to treat mitral valve stenosis, which is the valve responsible for regulating blood flow between the left atrium and the left ventricle. When this valve becomes narrow, it hinders the natural flow of blood from the left atrium to the left ventricle, affecting the efficiency of heart function.
It is recommended to perform the mitral valve expansion by balloon procedure in case medical treatment fails to treat mitral valve stenosis. This procedure is considered effective in cases where the mitral valve leaflets are flexible and suitable for the balloon expansion technique.
Mitral Valve Symptoms
The mitral (bicuspid) valve is one of the four heart valves and controls blood flow between the left atrium and the left ventricle. Several problems may affect it, such as stenosis, regurgitation, or prolapse. Mitral valve symptoms share most of them, including:
- Shortness of breath, especially when exerting effort or lying down.
- Fatigue, exhaustion, and decreased ability to tolerate exercise.
- Heart palpitations or feeling irregular heartbeats.
- Cough or chest discomfort as a result of fluid accumulation in the lungs.
- Swelling of the ankles, feet, or abdomen.
- Dizziness or fainting in advanced cases.
The severity of mitral valve symptoms varies according to the type and degree of the problem. Therefore, Professor Dr. Mohamed El-Ghannam advises early detection with heart ultrasound (Echo) when any of these symptoms appear to determine the problem and appropriate treatment.
Mitral Valve Stenosis Symptoms
Mitral valve stenosis occurs when the valve opening narrows, hindering blood flow from the left atrium to the left ventricle, which raises pressure in the atrium and lungs. Mitral valve stenosis symptoms include:
- Shortness of breath, especially during exertion or when lying down.
- Fatigue or decreased ability to tolerate exercise.
- Swelling of the ankles, feet, or abdomen.
- Heart palpitations resulting from atrial fibrillation.
- Cough or chest discomfort resulting from fluid accumulation in the lungs.
Mitral valve stenosis resulting from rheumatic fever is a common cause of stenosis in adults, and it is one of the most important indications for performing the mitral valve expansion by balloon procedure.
Mitral Valve Regurgitation and its Degrees
Mitral valve regurgitation is the failure of the valve to close tightly, allowing part of the blood to return to the left atrium instead of flowing entirely into the left ventricle. Doctors classify mitral valve regurgitation degrees according to the amount of returned blood and the severity of regurgitation as follows:
1.Degree One (Simple Regurgitation): The amount of returned blood is very small and often does not cause symptoms, and only requires periodic follow-up.
2.Degree Two (Mild Moderate Regurgitation): A slightly larger amount of returned blood with closer follow-up.
3.Degree Three (Moderate to Severe Regurgitation): A noticeable amount of returned blood and symptoms may begin to appear.
4.Degree Four (Severe Regurgitation): A large amount of returned blood may lead to heart enlargement and clear symptoms, and often requires surgical intervention to repair or replace the valve.
Professor Dr. Mohamed El-Ghannam determines the degree of mitral valve regurgitation accurately by heart ultrasound, then sets the appropriate treatment plan for each degree.
Does Mitral Valve Regurgitation Develop?
Yes, mitral valve regurgitation may develop over time, especially in moderate and severe cases or when neglecting follow-up. Regurgitation may start simple and stable for years without symptoms, but it may gradually increase with age or as a result of associated heart diseases or heart muscle weakness, which increases the amount of returned blood and causes enlargement of the left atrium and ventricle. Therefore, periodic follow-up with Echo with Professor Dr. Mohamed El-Ghannam is necessary to monitor any development in mitral valve regurgitation and intervene at the appropriate time before the heart muscle is affected.
Mitral Valve Prolapse and What is its Treatment?
Mitral valve prolapse (mitral valve prolapse) is a common condition that occurs when the mitral valve leaflets bulge or relax into the left atrium during heart contraction, which may prevent the valve from closing tightly and sometimes lead to blood regurgitation. Often mitral valve prolapse is simple and does not cause symptoms, but it may be accompanied in some cases by palpitations, mild chest pain, fatigue, and dizziness.
What is the Treatment for Mitral Valve Prolapse?
Treatment for mitral valve prolapse depends on its severity and the presence of regurgitation or not:
- In simple cases without regurgitation or symptoms: It does not need medical treatment, but periodic follow-up with Echo and reassuring the patient, with a healthy lifestyle.
- In case of symptoms such as palpitations: The doctor may prescribe medications such as beta-blockers to regulate the heartbeat.
- In cases accompanied by severe regurgitation: The patient may need mitral valve repair or surgical replacement or via minimally invasive surgical intervention techniques.
Professor Dr. Mohamed El-Ghannam emphasizes that most cases of mitral valve prolapse are simple and only need follow-up, and that surgical treatment is resorted to only when there is severe regurgitation affecting the heart muscle.
Advantages of Mitral Valve Expansion by Balloon Procedure
- A minimally invasive and safe procedure, as it spares the patient the risks of general anesthesia.
- No need for a surgical incision in the chest or using a heart-lung machine.
- Patients can stand the day after the operation.
- Most patients can leave the hospital the next day.
- No need to use blood thinners after the operation.
- Relieving symptoms and improving the quality of life for those affected by mitral valve stenosis.
Candidates for Performing the Mitral Valve Expansion by Balloon Procedure
Candidates for this procedure are patients who have flexible and non-calcified mitral valve leaflets, with no noticeable regurgitation (leakage) in the mitral valve, and no clot in the left atrium.
Patients Not Eligible for Mitral Valve Expansion by Balloon
Performing the mitral valve expansion by balloon procedure is not recommended in the following cases:
- Patients suffering from excessive calcification in the mitral valve.
- Patients suffering from a blood clot in the left atrium.
- Patients suffering from moderate or severe regurgitation in the mitral valve, unlike simple mitral valve regurgitation.
Reasons for Performing the Mitral Valve Expansion by Balloon Procedure
The main reason for performing the mitral valve expansion by balloon procedure is to treat mitral valve stenosis and treat the symptoms the patient suffers from, such as:
- Shortness of breath, especially during exertion or when lying down.
- Fatigue or decreased ability to tolerate exercise.
- Swelling of the ankles, feet, or abdomen.
- Heart palpitations resulting from atrial fibrillation.
- Cough or chest discomfort resulting from fluid accumulation in the lungs.
The procedure can also be performed for patients suffering from mitral valve stenosis resulting from rheumatic fever, which is a common cause of valve stenosis in adults.
Mitral Valve Expansion by Balloon Procedures
Before performing the mitral valve expansion by balloon procedure, Professor Dr. Mohamed El-Ghannam explains the nature of the procedure to the patient, including the steps of the procedure, its risks, and benefits. He also performs a comprehensive evaluation of the patient, and diagnostic evaluations usually include the following:
1.Heart Ultrasound (2D/3D): The most important diagnostic test to diagnose mitral valve stenosis, evaluate its severity, measure valve area, pressure gradients, and degree of calcification.
2.Transesophageal Echocardiogram (TEE): Provides detailed images to exclude clots in the left atrium.
3.Electrocardiogram (ECG): To detect heart rhythm disturbances such as atrial fibrillation.
4.Cardiac Catheterization: To measure pressure inside the heart and lungs.
5.Chest X-ray: To evaluate heart muscle enlargement and lung congestion.
Instructions Before the Procedure
Professor Dr. Mohamed El-Ghannam advises patients before the procedure to fast for 6-8 hours before the procedure, and stop taking blood thinners before the procedure.
Steps for Mitral Valve Expansion by Balloon
The following are the steps for the mitral valve expansion by balloon procedure with Professor Dr. Mohamed El-Ghannam:
1.The procedure is performed under local anesthesia for the right or left thigh area, and sedatives to help the patient relax.
2.Installing the catheter (a very thin tube) in one of the veins in the thigh.
3.Guiding the catheter to the right atrium of the heart, using X-ray images and heart ultrasound to accurately image heart structures and blood vessels.
4.Passing a contrast dye through the catheter, which improves the visibility of the narrow heart valve.
5.The doctor punctures the wall separating the right and left atrium (atrial septum) to reach the left atrium, then places the balloon inside the narrow heart valve and inflates and deflates it several times to fully widen the valve opening and improve blood flow.
6.After successfully opening the valve, the balloon is deflated and removed with the catheter.
7.The procedure usually takes about one hour, and the patient may need
Cost of Mitral Valve Expansion by Balloon Procedure
There are a set of factors responsible for determining the cost of the mitral valve expansion by balloon procedure, such as:
- The extent of the heart surgeon’s experience and competence in performing this type of operation.
- The cost of the hospital where the operation will be performed.
- The cost of diagnostic tests and tests required before the operation.
- The duration of the patient’s stay in the hospital.
- The type and quality of the balloon.
What’s After Mitral Valve Expansion by Balloon?
After completing the mitral valve expansion by balloon procedure, the patient is transferred to the cardiac intensive care unit to monitor vital signs and detect any complications. The patient may need to spend one night in the hospital for monitoring in case of any new symptoms, as this procedure may cause complications such as acute mitral valve regurgitation, pericardial injury, or embolism.
In case the heart ultrasound test results are good, the patient can leave the hospital the next day. Professor Dr. Mohamed El-Ghannam advises resting for a few days at home while avoiding lifting heavy objects, then the patient can resume their daily activities gradually during the following two weeks. The patient must also continue follow-up with the doctor for 3 months after the operation, and if the results are good, the patient can visit the doctor every 6 months.
Success Rate of Mitral Valve Expansion by Balloon Procedure
The success rate of the mitral valve expansion by balloon procedure is more than 95%, as results can last for 10-15 years. This rate depends on the doctor’s competence and the severity of the mitral valve disease and the valve condition. Also, most patients feel immediate improvement in symptoms after the operation and a noticeable improvement in the ability to exercise.
My Experience with Mitral Valve Prolapse
One of Professor Dr. Mohamed El-Ghannam’s patients tells his experience, saying: My journey with mitral valve prolapse began when I noticed frequent heart palpitations and unexplained fatigue when exerting any effort, so I decided to visit the doctor. After performing a heart ultrasound, Professor Dr. Mohamed El-Ghannam explained to me that my condition was simple mitral valve prolapse that does not warrant concern, and that most cases are simple and only need periodic follow-up and a healthy lifestyle.
The doctor reassured me that simple mitral valve prolapse does not affect my normal life, and prescribed a simple medication to regulate the heartbeat with follow-up every 6 months. Through my experience with mitral valve prolapse, I advise everyone who feels similar symptoms not to worry and head early to a specialized cardiologist, as early diagnosis and follow-up are the basis for reassurance and living normally.
Book Your Appointment with Professor Dr. Mohamed El-Ghannam
In conclusion, if you need to perform a mitral valve expansion by balloon procedure or have any inquiries about it or about mitral valve symptoms and treatment, do not hesitate and book your appointment now with Professor Dr. Mohamed El-Ghannam, Consultant of Open-Heart Surgery and Minimally Invasive Surgical Intervention, to discuss the details of the operation including its advantages, steps, and what to expect after it.
To book an appointment, please call the clinic’s own number 01211979117 or by visiting the doctor’s website info@mohamedelghanam.com, or by visiting one of the doctor’s clinics which include:
- Nasr City Clinic.
- Heliopolis Clinic.
Frequently Asked Questions
What is the cost of the mitral valve expansion by balloon procedure?
The cost of the mitral valve expansion by balloon procedure is affected by a set of factors, such as the doctor’s experience and competence, the cost of tests required before the operation, the type and quality of the balloon used, and the hospital cost and duration of stay. To inquire about the price with Professor Dr. Mohamed El-Ghannam, you can visit his clinics or call 01211979117.
What is the success rate of the heart valve expansion procedure?
The success rate of the heart valve expansion by balloon procedure may reach more than 90%. This rate depends on the severity of the mitral valve stenosis and its condition, the patient’s age and health condition, and the doctor’s competence and experience in performing this type of operation.
What are the degrees of mitral valve regurgitation and does it develop?
Mitral valve regurgitation degrees range from degree one (simple) to degree four (severe) according to the amount of returned blood. Yes, mitral valve regurgitation may develop over time especially in moderate and severe cases or with neglect of follow-up, so periodic follow-up with Echo is important to monitor any development and appropriate intervention.
What is the treatment for mitral valve prolapse?
Most cases of mitral valve prolapse are simple and only need periodic follow-up and a healthy lifestyle. In case of palpitations, medications such as beta-blockers may be prescribed. As for cases accompanied by severe regurgitation, the patient may need valve repair or replacement surgically or by minimally invasive surgical intervention.
Is the balloon heart procedure dangerous?
Mitral valve expansion by balloon is considered safe and less invasive than open-heart surgery, but it may carry simple complications such as bleeding or minor bruising at the catheter site, temporary heart rhythm disturbances, mitral valve regurgitation, and blood clots. Therefore, it is recommended to perform it with a doctor who possesses experience in these techniques such as Professor Dr. Mohamed El-Ghannam.
