Valvuloplasty, Tricuspid Valve; Without Ring Insertion

Name of the Procedure:

• Common Name: Tricuspid Valve Valvuloplasty
• Medical Term: Percutaneous Tricuspid Balloon Valvuloplasty (PTBV)

Summary

Valvuloplasty for the tricuspid valve is a minimally invasive procedure to repair a damaged tricuspid valve that controls blood flow between the right atrium and right ventricle of the heart. Without inserting an artificial ring, the procedure typically involves using a balloon catheter to widen the narrowed valve.

Purpose

This procedure is intended to:

• Address tricuspid valve stenosis, which is the narrowing of the tricuspid valve.
• Improve blood flow and reduce symptoms such as fatigue, swelling, and shortness of breath.
• Enhance overall heart function and quality of life.

Indications

• Symptoms of tricuspid valve stenosis such as edema, ascites, or jugular vein distension.
• Echocardiogram or other imaging showing significant tricuspid stenosis.
• Patient is considered a poor candidate for open-heart surgery due to age, frailty, or other health issues.

Preparation

• Patients may be instructed to fast for 6-8 hours prior to the procedure.
• Adjustments to medications, particularly anticoagulants, may be necessary.
• Pre-procedure tests: Blood tests, echocardiogram, ECG, and possibly a cardiac MRI.

Procedure Description

1. The patient is sedated or given local anesthesia.
2. A small incision is made, usually in the groin, to access a major blood vessel.
3. A catheter with a deflated balloon at its tip is threaded through the blood vessel to the heart.
4. Once positioned within the tricuspid valve, the balloon is inflated to widen the valve opening.
5. The balloon is then deflated and removed, along with the catheter.
6. The incision site is closed and bandaged.

Duration

The procedure typically takes 1-2 hours.

Setting

• This procedure is performed in a hospital, specifically in a catheterization lab or a specialized cardiac unit.

Personnel

• Interventional Cardiologist
• Cardiac Surgeon
• Anesthesiologist or nurse anesthetist
• Trained nursing staff
• Radiologic Technologist

Risks and Complications

• Common risks: Bleeding at the incision site, infection, arrhythmias.
• Rare risks: Valve rupture, stroke, damage to the heart or blood vessels.
• Management of complications could involve medications, additional procedures, or surgery.

Benefits

• Improved blood flow through the heart.
• Reduction in symptoms like fatigue and edema.
• Enhanced quality of life, often noticeable within a few days post-procedure.

Recovery

• Patients typically stay in the hospital for 1-2 days for monitoring.
• Rest and avoid strenuous activities for a few days to a week.
• Follow-up appointments to monitor heart function via echocardiogram and ECG.
• Pain management with prescribed medication if necessary.

Alternatives

• Medications to manage symptoms of tricuspid stenosis, although they do not repair the valve.
• Tricuspid valve replacement surgery, either via open-heart surgery or minimally invasive techniques.
• Pros and cons: Medications are less invasive but less effective long-term, while valve replacement offers a more permanent solution but with higher risks and longer recovery.

Patient Experience

• During the procedure: Minimal discomfort as sedation or anesthesia is used.
• After the procedure: Mild soreness at the incision site, temporary fatigue.
• Pain management: Analgesics may be provided for any post-procedural discomfort.