Aortic Stenosis - Balloon Aortic Valvotomy

Introduction

The heart has four valves that make sure blood flows the right way. The aortic valve sits between the left ventricle (the main pumping chamber) and the aorta (the big artery that carries blood to the body).

In some children, this valve is narrow or stiff. This is called aortic stenosis.

It can happen if:

  • The valve has only one or two flaps instead of three.
  • The valve tissue is thick and does not open properly.

 Signs and symptoms

When the valve is tight, the heart has to work harder to push blood out. Over time, this can make the heart muscle thick.

Children with mild narrowing often have no symptoms, but more severe cases can cause:

  • chest pain
  • tiredness
  • dizziness (especially during exercise)
  • fainting spells
  • shortness of breath

If the narrowing is serious, treatment is needed to help the valve open and reduce strain on the heart.

Diagnosis

A doctor can diagnose aortic stenosis by:

  • listening to the heart: they may hear a murmur
  • echocardiogram (heart ultrasound): shows how tight the valve is and how well the heart pumps
  • electrocardiogram (ECG): checks heart rate and rhythm
  • cardiac catheterisation: sometimes used to measure pressure inside the heart and confirm how tight the narrowing is
  • If you have questions, contact your child’s cardiologist or cardiac nurse. They are here to help you and your family.

Treatment

Balloon Aortic Valvotomy (BAV) 

BAV is a safe procedure done in the cardiac catheterisation laboratory (cath lab) to stretch open the narrowed valve without open-heart surgery. It helps the heart pump better and most children recover quickly.

The procedure is done under general anaesthetic, so your child will be asleep and feel no pain

A small tube (catheter) goes into a blood vessel in the leg (groin)

An angiogram (special movie X-ray) checks the valve

The doctor moves the catheter to the heart and across the valve

A balloon on the catheter is inflated for a few seconds to stretch the valve, then deflated and removed

The tube is taken out, and a small dressing is put on the leg

The procedure takes about 1–2 hours

 Management

Risk and complications

Balloon aortic valvotomy is a safe and well-known procedure, but risks include:

  • bruising or bleeding at the catheter site
  • temporary irregular heartbeat
  • mild leakage of blood backwards through the valve
  • valve narrowing again over time (may need another procedure)
  • infection
  • damage to blood vessels or valve- very rare

Your child’s doctor will explain these risks and answer questions before the procedure.

Caring for your child after the procedure

In hospital:

  • your child will wake up in the recovery area and is closely monitored
  • the leg used for the catheter must stay straight for a few hours
  • most children can eat and drink when awake
  • an echocardiogram will be done to check the valve before going home
  • most children go home the next day

At home:

  • remove the dressing after 24 hours.
  • avoid soaking in water (baths or swimming) for 72 hours to allow the access site to heal. Quick showers are okay
  • your child can go back to school or daycare after 2 days
  • no rough play, cycling or contact sports for about a week. Your doctor will confirm when it’s safe
  • your child will have regular follow-up visits and heart scans to check the valve.