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Learn About Conditions and Procedures

What is Trauma?

Trauma is a serious injury or shock to the body. It is caused by a physical force such as violence or an accident. The injury may be complicated by psychiatric, behavioral, and social factors.

It is critical to have an entire team immediately available to provide care to an injured patient 24-hours a day. This teamwork starts at the scene of the injury where a coordinated, statewide pre-hospital medical system rapidly transports the injured patient from the scene to the hospital providing the appropriate level of care according to criteria established in the statewide trauma regulations. Once at the hospital, a complete team of surgeons, emergency physicians and nurses continue the life-saving treatment.

This team approach to care of the injured patient has had a dramatic impact on saving lives.

Minimally Invasive Procedures for Massive Bleeding

Injuries take many forms. The most advanced hospitals can treat injuries with a variety of approaches that involve well-known ones, like surgery, and newer ones where minimally invasive procedures can replace some surgeries.

As a Level 1 Trauma Center, Hartford Hospital has Interventional Radiologists as part of the Trauma Team. They perform procedures such as "embolization" which is a recognized interventional radiology technique that is used to treat trauma patients with massive bleeding.

Click here to see some of the advanced interventional techniques available at Hartford Hospital.

Learn more about trauma, or search below to learn about other health conditions.

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Percutaneous Balloon Valvuloplasty

(Percutaneous Commissurotomy)

Pronounced: Purr-cue-TAY-knee-us BA-loon VAL-view-low-PLAS-tee

by Ricker Polsdorfer, MD

En Español (Spanish Version)

Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor

Definition

Percutaneous balloon valvuloplasty is done to open a constricted heart valve with a balloon.

Mitral Valve Stenosis

Reasons for Procedure

Any of the heart’s four valves can become deformed. It may happen because of conditions at birth or scarring from disease. A damaged valve can decrease the amount of blood that flows through it. This condition is called stenosis. Low blood flow can lead to heart failure and death. The valve will need to be opened to restore full blood flow.

Rheumatic fever and congenital birth defects are two main causes of stenosis. It can also happen due to aging and calcium deposits.

Depending on the overall condition of the valve, relief of symptoms can be expected to last at least two years. Some people have relief of symptoms much longer.

Possible Complications

If you are planning to have a valvuloplasty, your doctor will review a list of possible complications, which may include:

Bleeding
Infection
Leaking valve
Damage to the heart or other organs
Blood clot formation
Stroke

Some factors that may increase the risk of complications include:

Smoking
Blood clots in the heart
The anatomy of the valve
Overall health status

What to Expect

You will have a thorough evaluation to determine your overall condition, the health of your heart, and the exact nature of your valve defect. The success of the procedure depends a great deal on the condition of the valve. This includes whether the valve is calcified, how thick it is, and how narrow the opening is. Many valves cannot be fixed with this technique. They will require open heart surgery instead.

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

Aspirin or other anti-inflammatory drugs
Blood thinners

Only local anesthesia and, sometimes, mild sedation are used. Local anesthesia will numb the area. Sedation will help you relax.

You will be lying down in a special procedure room. There will be x-ray machines and surgical equipment. Depending on the valve that needs work, a blood vessel in your groin or arm will be prepared. A wire will be placed through your skin to the blood vessel. It will be passed through the blood vessel until it reaches the valve. Progress will be monitored by x-rays. A tube with a balloon tip will be threaded over the wire. A contrast material may be injected through the device. This will help to visualize the area and make sure the device is in the right place. When the balloon is in the valve, it will be inflated and deflated. The inflation may need to be repeated. The device will then be removed from the blood vessel.

You will likely need to lie still and flat on your back for a period of time. A pressure dressing may be placed over the puncture area. It is important to follow the nurses' directions.

Between 30 minutes and two hours

You may feel some minor discomfort when the balloon is inflated. Some people report a flushing sensation if contrast is injected.

Most people are kept overnight for observation. Your doctor may choose to keep you longer if complications arise.

Recovery time is minimal. There will be a bandage over the puncture site. You may be prescribed a blood thinner, like aspirin. Certain strenuous activities will be limited. Other activities, like exercises and fluid intake, may be encouraged. Your doctor will want to see you several days to weeks later.

Be sure to follow your doctor's instructions .

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:

Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or any discharge from the puncture site
Pain that you cannot control with the medicines you have been given
Lightheadedness, fainting, or inability to talk
Cough, shortness of breath, or chest pain
An arm or a leg that turns blue or feels cold
Any other new symptoms

In case of an emergency, call for medical help right away.

American Heart Association

http://www.heart.org

The Society of Thoracic Surgeons

http://www.sts.org

Health Canada

http://www.hc-sc.gc.ca

Heart and Stroke Foundation of Canada

http://ww2.heartandstroke.ca

American Heart Association. Percutaneous balloon aortic valvuloplasty: acute and 30-day follow-up results in 674 patients from the NHLBI balloon valvuloplasty registry. Circulation. 1991;84:2383-2397.

Chen CR, et al. Percutaneous balloon valvuloplasty for pulmonic stenosis in adolescents and

adults. N Engl J Med. 1996;33:21-25.

Kiwan Y, et al. Mitral balloon valvuloplasty by Inoue technique without echocardiographic standby. Ann Saudi Med. 1994 Sep;14(5):375-8.

Tarka EA, Blitz L, Herrmann HC. Hemodynamic effects and long-term outcome of percutaneous balloon valvuloplasty in patients with mitral stenosis and atrial fibrillation. Clin Cardiol. 2000;23:673-677.

6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

Last reviewed May 2013 by Ganson Purcell Jr., MD, FACOG, FACPE; Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.