Before the procedure
Your doctor will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.
You will be asked to sign a consent form that gives your permission to do the test. Read the form carefully and ask questions if something is not clear.
Notify your doctor if you have ever had a reaction to any contrast dye, or if you are allergic to iodine.
Notify your doctor if you are sensitive to or are allergic to any medications, latex, tape, or anesthetic agents (local and general).
You will need to fast for a certain period of time prior to the procedure. Your doctor will notify you how long to fast, usually overnight.
If you are pregnant or suspect that you may be pregnant, you should notify your doctor.
Notify your doctor if you have any body piercings on your chest and/or abdomen.
Notify your doctor of all medications (prescription and over-the-counter) and herbal supplements that you are taking.
Notify your doctor if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop some of these medications prior to the procedure.
Your doctor may request a blood test prior to the procedure to determine how long it takes your blood to clot. Other blood tests may be done as well.
Notify your doctor if you have a pacemaker.
You may receive a sedative prior to the procedure to help you relax.
Based on your medical condition, your doctor may request other specific preparation.
During the procedure
A valvuloplasty may be performed as part of your stay in a hospital. Procedures may vary depending on your condition and your doctor’s practices. Generally, a valvuloplasty follows this process:
You will be asked to remove any jewelry or other objects that may interfere with the procedure. You may wear your dentures or hearing aids if you use either of these.
You will be asked to remove clothing and will be given a gown to wear.
You will be asked to empty your bladder prior to the procedure.
An intravenous (IV) line will be started in your hand or arm prior to the procedure for injection of medication and to administer IV fluids, if needed.
You will be placed in a supine (on your back) position on the procedure table.
If there is excessive hair at the catheter insertion site (groin area), the hair may be clipped off.
You will be connected to an ECG monitor that records the electrical activity of the heart and monitors the heart during the procedure using small, adhesive electrodes. Your vital signs (heart rate, blood pressure, breathing rate, and oxygenation level) will be monitored during the procedure.
There will be several monitor screens in the room, showing your vital signs, the images of the catheter being moved through the body into the heart, and the structures of the heart as the dye is injected.
You will receive a sedative medication in your IV before the procedure to help you relax. However, you will likely remain awake during the procedure
Your pulses below the injection site will be checked and marked so that the circulation to the limb below the site can be checked after the procedure.
A local anesthetic will be injected into the skin at the insertion site. You may feel some stinging at the site for a few seconds after the local anesthetic is injected.
Once the local anesthetic has taken effect, a sheath, or introducer, will be inserted into the blood vessel. This is a plastic tube through which the catheter will be inserted into the blood vessel and advanced into the heart.
The valvuloplasty catheter will be inserted through the sheath into the blood vessel. The doctor will advance the catheter through the vein or artery across the heart valve. Fluoroscopy (a special type of X-ray that will be displayed on a TV monitor) may be used to assist in advancing the catheter to the heart.
Once the catheter is in place, contrast dye will be injected through the catheter into the valve in order to look at the area. You may feel some effects when the contrast dye is injected into the IV line. These effects include a flushing sensation, a salty or metallic taste in the mouth, or a brief headache. These effects usually last for a few moments.
You should notify the doctor if you feel any breathing difficulties, sweating, numbness, itching, chills, nausea and/or vomiting, or heart palpitations.
The doctor will watch the contrast dye injection on a monitor. The doctor may ask you to take a deep breath and hold it for a few seconds.
Once the balloon is in place and has been inflated, you may notice some dizziness or even brief chest discomfort. This should subside when the balloon is deflated. However, if you notice any severe discomfort or pain, such as chest pain, neck or jaw pain, back pain, arm pain, shortness of breath, or breathing difficulty, tell your doctor.
The balloon may be inflated and deflated several times in order open the valve.
Once it has been determined that the valve is opened sufficiently, the catheter will be removed. The catheter insertion site may be closed with a closure device that uses collagen to seal the opening in the artery, by the use of sutures, or by applying manual pressure over the area to keep the blood vessel from bleeding. Your doctor will determine which method is appropriate for your condition.
If a closure device is used, a sterile dressing will be applied to the site. If manual pressure is used, the doctor (or an assistant) will hold pressure on the insertion site so that a clot will form. Once the bleeding has stopped, a very tight bandage will be placed on the site. A small sandbag or other type of weight may be placed on top of the bandage for additional pressure on the site, especially if the site is in the groin.
Your doctor may decide not to remove the sheath, or introducer, from the insertion site for approximately four to six hours, in order to allow the effects of blood-thinning medication given during the procedure to wear off. You will need to lie flat during this time. If you become uncomfortable in this position, your nurse may give you medication to make you more comfortable.
You will be assisted to slide from the table onto a stretcher so that you can be taken to the recovery area. NOTE: If the insertion was in the groin, you will not be allowed to bend your leg for several hours. To help you remember to keep your leg straight, the knee of the affected leg may be covered with a sheet and the ends tucked under the mattress on both sides of the bed to form a type of loose restraint.