What is a Cardiac Valve Repair?

A cardiac valvulotome is a specialized surgical instrument used during cardiac valvuloplasty procedures. It is a metallic tool that is inserted through the vasculature and guided into the heart using imaging such as fluoroscopy. The valvulotome is then used to cut or score stenotic heart valves to restore normal blood flow and reduce valve stenosis.

Types of Cardiac Valve Repair
There are different types of valvulotomes designed for specific cardiac valves and procedures:

Mitral Valvulotome: Used to treat mitral stenosis, it has curved blades that can be opened within the mitral valve to cut and score valve leaflets. The open and closed position can be controlled via an outer sheath.

Aortic Valvulotome: For treating aortic stenosis, it has straight blades that can be rotated longitudinally to score calcified aortic valve leaflets. An atraumatic tip prevents injuries to surrounding tissues during insertion.

Pulmonic Valvulotome: To dilate the pulmonic valve in cases of pulmonic stenosis, it has a similar design as the aortic valvulotome but with a smaller diameter.

Tricuspid Valvulotome: Cardiac Valvulotome For treating rare cases of tricuspid stenosis, it has specialized curved blades to safely cut valve leaflets without injuring the surrounding tricuspid apparatus.

Valvuloplasty Procedure

In a standard cardiac valvuloplasty procedure:

- The patient is put under general anesthesia and sterile technique is followed.

- A guiding catheter or sheath is inserted through a peripheral vein/artery and guided into the heart chambers under fluoroscopic guidance.

- The valvulotome is loaded on a wire guide and passed through the guiding catheter/sheath into the target stenotic valve under imaging.

- The valvulotome blades are opened/rotated to score the stenotic valve leaflets, cutting calcific plaques or thickened tissues.

- The valvulotome is removed and the dilated valve is assessed using techniques like angiography or echocardiography.

- If needed, the valvuloplasty may be repeated with larger valvulotomes to achieve optimal valve dilation.

- The guiding catheter/sheath is removed and the vascular access site is closed. The patient is monitored in recovery.

Advantages of Valvuloplasty

Some key advantages of treating valve stenosis with cardiac valve repair assisted valvuloplasty include:

- Minimally invasive nature - It can be performed through small vascular accesses like the femoral artery/vein under local anesthesia.

- Lower risk - The risk of complications is much lower than open-heart valve replacement surgery.

- Quick recovery - Patients have faster recovery times and shorter hospital stays compared to open surgery.

- Delayed surgery - It can help delay the need for definitive surgical valve replacement in certain patients.

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