Rheumatic mitral stenosis
Mitral dilatation
Mitral valve balloon dilatation
Mitral dilatation
The image on the left shows the balloon used for mitral dilatation (on the right) in angiography.
What is mitral dilatation?
Mitral dilatation is a procedure aimed at relieving the blockage to the filling of your ventricle. Following rheumatic fever contracted in the past, the mitral valve located between the left atrium and the left ventricle has narrowed due to "fusions" of its commissures, causing difficulty during heart filling and clinically the shortness of breath you feel.
How is mitral dilatation performed?
Your test will take place in the interventional cardiology unit.
Upon your admission to the cardiology department, you will be asked to wear a hospital gown. You will need to remove all your jewelry, underwear, and socks.
You may wear your glasses, dentures, and hearing aids if needed.
A small area of your groin will be shaved in case it is the access point for the procedure.
You will be asked to go to the bathroom to empty your bladder (urinate) just before your test.
A stretcher-bearer will take you to the catheterization room in your bed. You will be helped to lie down on a narrow, hard table.
It might be a bit cold in the room. Around you, you will see X-ray analysis devices and screens.
Small sticky patches will be placed on your chest. These will be connected to a heart monitoring device.
Your body will be covered with a large sterile drape.
This examination is performed under X-ray control, at doses as low as possible.
The doctor will administer a subcutaneous anesthetic in the vein of the right groin to reduce the sensation of pain. In some cases, general anesthesia will be performed, the goal of which is to guide the procedure using transesophageal echocardiography.
The dilatation is performed using an inflatable balloon catheter via the femoral vein. This balloon is placed at the level of the mitral valve by passing from the right atrium to the left atrium after making an opening through the wall that separates these two atria (trans-septal puncture).
The valve is then dilated by inflating the balloon to progressively larger sizes under echocardiographic control to achieve the best possible result.
Can I take my usual medications before the test?
You can take most of your usual medications the night before your test and on the day of the test. Your doctor will review with you the medications you are taking.
If you have any doubts about a medication, you should notify the doctor before your visit.
Can I eat and drink before this test?
You must fast for 12 hours before the exam.
Depending on the organization of the day, we try to respect the order and time of passage. However, depending on the emergencies of the day, the duration of the interventions of the day, it is possible to have a waiting time of several hours.
Are there any risks associated with mitral dilatation?
Despite technical progress in equipment and the experience of doctors, mitral dilatation, like any invasive or surgical procedure, carries a risk of incidents or accidents:
Allergic complications - Most often linked to the use of iodinated contrast product or local anesthetic.
If you have ever had allergic reactions, it is essential to inform the doctor before the examination.
Complications at the puncture site - These are rare. The most common complication is a hematoma which results in a bluish appearance, which can persist for several days but is usually without consequence. Exceptionally, surgical repair and/or a blood transfusion may be necessary.
Cardiac complications - Mobilization of a clot that can lead to a stroke is exceptional.
Injury to the heart envelope secondary to the creation of the hole between the two atria is rare and usually treated effectively by immediate drainage in the catheterization room (about 1%). Surgery is rarely necessary.
A valve tear may occur (about 3% of cases). It is unpredictable but the risk is reduced by the use of echocardiography during the procedure. It may require surgery which is exceptionally necessary in an emergency.
Failure of dilatation:
The narrowing may be impossible to cross or dilate. The failure rate of the procedure is around 5 to 10%. In this case, a classic surgical intervention can always be considered in a second stage.
What benefits can be expected from mitral dilatation?
By allowing normal passage of blood between the left atrium and the left ventricle, mitral dilatation improves long-term outcomes and in particular reduces your shortness of breath.
The progression of the disease means that the narrowing can recur at a distance. The average delay is 7 to 12 years. This restenosis can be treated by a new dilatation or surgery depending on the appearance of the valve.
How long will I be in bed after the test?
You must remain in bed for about two hours without bending the leg used for the puncture too much. The head of the bed can be slightly raised for eating. After 4 hours of bed rest, you will be able to get up. You will spend the night under observation.
Mitral stenosis
Mitral valve dilatation
Our location
Make an appointment
LUH Les Ambassadeurs
Appointment
Monday - Friday: 8 a.m. - 3:30 p.m.
Visit us
Insurance
At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance.
Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need.