valvoplasty

Valvoplasty is a medical procedure aimed at repairing a diseased heart valve in order to preserve the native valve tissue rather than replace it. It encompasses percutaneous balloon valvuloplasty as well as various surgical valvoplasty techniques. The goal is to relieve valve obstruction or improve valve function while minimizing the need for valve replacement.

Percutaneous balloon valvuloplasty uses a catheter with an inflatable balloon that is advanced to the stenotic valve under imaging guidance. When inflated, the balloon dilates the valve opening and can split fused leaflets or commissures, improving blood flow. This approach is commonly used for mitral, aortic, or pulmonary stenosis and is sometimes chosen as a bridge to surgery or as palliation in selected patients. Surgical valvoplasty refers to open or closed procedures performed to repair a valve, including commissurotomy (splitting of fused leaflets), chordal or leaflet repair, and annular reduction or augmentation. These techniques aim to restore valve competence and size while reducing or delaying the need for valve replacement.

Indications generally include symptomatic stenosis with favorable valve anatomy or regurgitation that is amenable to repair. Contraindications include extensive calcification, poor tissue quality, or valves unlikely to function adequately after repair. Outcomes vary by valve involved and patient factors; balloon valvuloplasty is less invasive with quicker recovery but can have higher rates of recurrent stenosis or new regurgitation, potentially necessitating later intervention. Surgical valvoplasty may offer more durable results in suitable cases. Risks include bleeding, vascular injury, infection, arrhythmias, stroke, and valve dysfunction.