Percutaneous balloon dilation for heart valve disease

  Rheumatic fever often causes heart valve adhesions, thickening, and calcification, resulting in stenosis, most often causing mitral stenosis. The indications for percutaneous mitral valve balloon dilatation and the surgical approach are divided as follows: Indications ① mitral valve orifice area less than 1.5 cm2, up to moderate or above moderate stenosis; ② valve without calcification and still good mobility; ③ no valve closure insufficiency; ④ no appendage thrombus in the left atrium; ⑤ better results and greater significance in younger patients.  Procedure: With a balloon catheter to puncture the femoral vein up to the atrium, puncture the interatrial septum to the left atrium, reach the mitral valve, use one or two tubular balloons, span the mitral valve orifice, and then repeat inflation until the balloon dilates, causing the valve adhesions to separate and expand 1-fold in area or more than 1.5-2 cm2, and measure the diastolic pressure step difference across the mitral valve orifice to decrease.  Percutaneous balloon pulmonary angioplasty (PBPV) has become the current method of choice for the treatment of simple right ventricular outflow tract obstruction. Indications: typical pulmonary stenosis with a pressure step difference between the pulmonary artery and the right ventricle at normal cardiac output ≥ 6.67 kPa (50 mmHg) is an absolute indication for PBPV treatment; and typical pulmonary stenosis with an ECG showing right ventricular enlargement, right ventriculogram showing pulmonary artery dilatation, presence of jet sign, and a pressure step difference across the pulmonary valve of 4.67 kPa~6.67 kPa ( 35mmHg~50mmHg) as a relative indication for PBPV treatment.  Percutaneous aortic balloon valvuloplasty, which was performed earlier to treat aortic stenosis, has significantly limited the use of this technique in clinical practice because of efficacy and safety concerns. Because the anatomic features and location of the tricuspid valve are very different from those of the aortic and pulmonary valves, interventions related to it are still under investigation.