Ballon-Mitral-Valvuloplastie (Mitral-Stenose-Behandlung)

Balloon mitral valvuloplasty, also called percutaneous mitral commissurotomy, opens a mitral valve narrowed by rheumatic heart disease. A balloon is passed through a leg vein into the heart and inflated across the valve to split the fused edges of its two leaflets.

In well-chosen valves it roughly doubles the valve area and relieves breathlessness for many years without surgery or a prosthetic valve. It does not cure rheumatic disease: the valve gradually narrows again, and it does not work for heavily calcified valves or those that also leak badly.

What Balloon Mitral Valvuloplasty (Mitral Stenosis Treatment) involves

A transoesophageal echo is done first to exclude clot in the left atrium and to score the valve. In the cath lab, a catheter is advanced from the right femoral vein to the right atrium and a fine needle punctures the thin wall between the upper chambers to reach the left atrium. Heparin is given. The Inoue balloon, an hourglass-shaped balloon, is floated across the mitral valve; its far end is inflated first, pulled back to anchor on the valve, and then the whole balloon is inflated for a few seconds to split the commissures. Pressures on either side of the valve and the degree of any leak are measured after each inflation, and the balloon size is stepped up until the result is good.

Who is a good candidate for Balloon Mitral Valvuloplasty (Mitral Stenosis Treatment)?

The procedure is for moderate to severe rheumatic mitral stenosis, with valve anatomy judged favourable on echo, commonly using the Wilkins score.

• You have symptomatic mitral stenosis with a valve area of 1.5 square centimetres or less
• Your valve leaflets are pliable with little calcium, a Wilkins score of about 8 or lower
• There is no more than mild mitral regurgitation
• You have no clot in the left atrium on transoesophageal echo
• You are pregnant or planning pregnancy with significant stenosis, where avoiding surgery and warfarin matters and specialist advice has been taken

Es ist normalerweise nicht die richtige Wahl, wenn:

• You have a clot in the left atrium or its appendage
• You have moderate or severe mitral regurgitation
• The valve and the structures beneath it are heavily calcified or thickened
• You also need surgery for another valve or for coronary disease
• Your mitral stenosis is degenerative from calcium in the valve ring rather than rheumatic

Technikoptionen

• Inoue balloon technique: The worldwide standard. A single self-positioning balloon with stepwise sizing.
• Double balloon technique: Two smaller balloons side by side; an older alternative with similar results.
• Surgical mitral valve replacement or repair: Chosen when anatomy is unfavourable, the valve leaks, or clot persists despite anticoagulation.
• Intracardiac or transoesophageal echo guidance: Helps the septal puncture and gives immediate assessment of the result.

Was passiert während Ihrer Behandlung

It takes 1 to 2 hours under local anaesthetic and light sedation. You may feel brief light-headedness or palpitations while the balloon is inflated, since flow through the valve stops for a few seconds. You lie flat for about 6 hours afterwards and have an echo the next day to measure the new valve area. Most people stay 1 to 2 nights.

Vorbereitung auf Ihre Reise

One session. Allow 6 to 8 days in Istanbul for the transoesophageal echo, the procedure and the check echo. If the echo shows a clot, the procedure is postponed for 2 to 3 months of anticoagulation, so have the echo report reviewed remotely before booking, and accept that the plan may change on arrival.

• Informieren Sie den Arzt über Medikamente, Allergien, Schwangerschaft oder Stillen und eine Vorgeschichte von Fieberbläschen, Keloidnarben oder Autoimmunerkrankungen
• Vermeiden Sie Alkohol, Aspirin und entzündungshemmende Schmerzmittel für ein paar Tage im Voraus, wenn Ihr eigener Arzt zustimmt, um Blutergüsse zu reduzieren
• Kommen Sie ohne Make-up auf dem Behandlungsbereich an und vermeiden Sie zwei Wochen vorher Sonnenliegen und starke Sonne

Genesung und Ergebnisse

You can resume light activities within 2 to 3 days and avoid heavy lifting for a week. Breathlessness usually eases within days. If you have atrial fibrillation you continue anticoagulation exactly as before. Many people with rheumatic disease are advised to continue long-term penicillin prophylaxis. Yearly echo follow-up at home tracks gradual re-narrowing.

• Back to everyday activity: 2 to 7 days
• When results show: Breathing easier within days
• How long they last: Often 10 to 15 years before re-intervention

Sicherheit, Risiken und Revisionspolitik

In experienced centres serious complications occur in about 1 to 3 in 100 procedures.

• Severe mitral regurgitation from a torn leaflet, in about 2 to 5 in 100, sometimes needing urgent valve surgery
• Bleeding around the heart from the septal puncture
• Stroke or other embolism from dislodged clot
• A small residual hole in the atrial septum, which usually closes by itself
• Groin bruising or vein injury
• Insufficient opening of the valve
• Re-narrowing over years; roughly half of patients need another procedure or surgery within 10 to 15 years

Jeder schriftliche Vorschlag wird durch Clinic-Y gibt an, was die Klinik abdeckt, wenn eine Korrektur erforderlich ist. Fragen Sie danach, bevor Sie buchen, nicht danach.

Cost of Balloon Mitral Valvuloplasty (Mitral Stenosis Treatment) in Türkiye

Clinic-Y does not publish a single price for Balloon Mitral Valvuloplasty (Mitral Stenosis Treatment), because the honest figure depends on your case. What moves it:

• The single-use balloon system
• Transoesophageal echo and cath lab imaging
• Dauer des Krankenhausaufenthalts
• Whether surgical back-up or conversion to valve replacement becomes necessary
• Repeat echo and anticoagulation monitoring afterwards

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