What is pulmonary valve stenosis?
Pulmonary valve is the heart valve located at the mouth of the main artery (pulmonary artery) that carries the dirty blood returning from our body to the heart from the right ventricle (ventricle) to the lungs. Narrowing of the structure of this valve due to congenital structural or developmental disorder is called pulmonary valve stenosis. In severe pulmonary valve stenosis, the amount of blood pumped to the lungs decreases significantly, the pressure in the right ventricle increases, and as a result, the patient may experience chest pain, fainting, shortness of breath, heart failure and, rarely, sudden death.
Today, the first choice in the treatment of pulmonary valve stenosis is balloon valvuloplasty. Surgical treatment is only used if the balloon valvuloplasty procedure fails or if the patient's valve structure is not suitable for the balloon valvuloplasty procedure. Surgical treatment of pulmonary valve stenosis is repair of the valve with heart surgery. Balloon valvuloplasty provides treatment that eliminates the disease in most cases. In a small number of patients, the procedure may need to be repeated.
How is the pulmonary valve expansion procedure done with a balloon?
It is necessary to fast for 4-12 hours before the procedure (drugs can be taken with a very small amount of water). Before starting the procedure, the patient is put to sleep with anesthesia drugs given intravenously. The patient does not feel pain during the procedure. If the patient wishes, the groin area where the procedure will be performed is anesthetized locally and the procedure is performed while the patient is awake. With a special technique, a plastic tube system is placed in the vein in the groin, which will remain throughout the procedure and be removed at the end of the procedure, through which the balloon can be advanced. A long guidewire is advanced along the vein towards the heart until it reaches the pulmonary valve. The doctor uses a device (scopy) that uses x-rays to see the wire. After the wire passes through the pulmonary valve and is placed in the correct place within the pulmonary artery, the balloon is advanced over the wire, placed into the narrowed valve and inflated. Thus, the cover is expanded as much as possible. The balloon can be inflated several times. At the end of the procedure, the guide wire and balloon are removed. The plastic pipe system placed in the groin is removed after a while and a sandbag is placed on the attempted area, applying pressure for a while.
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