Pulmonic stenosis is a narrowing of one of the valves in the heart (the pulmonic valve). This congenital heart condition restricts blood flow through to the pulmonary artery, which takes blood to the lungs for oxygenation. As a consequence of this narrowing, blood flows through the valve at an increased velocity. This results in a ‘squirt’ of blood flow with each heart beat, which creates a sound called a murmur. The obstruction caused by the narrowed valve leads to an increased pressure in the right heart, and potentially heart failure (see www.heartydog.co.uk).

Balloon valvuloplasty involves passing a specially designed balloon-tipped catheter via the vein in the neck or back leg (‘keyhole’ surgery) into the heart and through the narrowed valve. After angiographic studies this sausage-shaped balloon is momentarily inflated to stretch the defective valve, allowing it to open more normally.

Martin Referrals is one of the few specialist centres in the UK regularly performing balloon valvuloplasty. We have considerable expertise with this procedure, averaging 10–15 operations each year, with scientific publications documenting our success.

The success rate is good with approximately 85% of cases showing a significant clinical improvement following surgery. However this procedure is not without risk and a small number of patients (approx. 5-7%) do not survive surgery.

Some important requirements for successful balloon valvuloplasty

• For best results, the procedure should be performed by a cardiologist experienced in balloon valvuloplasty.
• A thorough cardiac ultrasound scan by a cardiologist, to allow assessment of the severity of the stenosis and any possible complications.
• The choice of balloon diameter is very important, to ensure a good outcome.