Balloon aortic valvuplasty (BAV), is a minimally invasive procedure used to treat severe aortic stenosis alongside medications or used as an interim procedure while you await a surgical procedure.

What is a balloon aortic valvuplasty?

A balloon aortic valvuplasty (BAV), is a minimally invasive procedure used to treat severe aortic stenosis (narrowing of the aortic valve opening) alongside medications. It can also be used as a bridging procedure while you await a surgical transcatheter aortic valve implantation (TAVI) procedure, where a new artificial valve is inserted.

The procedure is done by inserting a small flexible tube called a catheter into the vessel, called an artery. Your doctor gains access to this artery through your groin and the catheter is threaded through the artery into your heart. X-ray machines are used to help guide the doctor as they are threading the catheter. The catheter, once in position, guides a wire across the diseased narrow aortic valve. A balloon catheter will then be moved across the aortic valve and will be inflated for a few seconds.

The inflation (expanding the balloon) stretches the hard aortic valve and cracks the calcium, which has made the valve hard. This allows the aortic valve to move a bit easier. When the aortic valve is more flexible, this improves blood flow through your heart and the rest of your body. Often your doctor will insert a pacemaker wire in your heart in order to improve safety of the procedure.

Where would I undergo a BAV and what is involved in the process?

In Fraser Health, the hospital which provides this service is Royal Columbian Hospital in New Westminster.

If you have aortic stenosis, you will be referred by your cardiologist to specialist in interventional cardiology to be evaluated for the procedure. The interventional cardiologist will provide you with specific preparation instructions for this procedure at that time. The procedure lasts approximately one hour long and is done in most cases with local anesthesia.

Typically you will be discharged on the same day, but you may be kept overnight for observation, as determined by your doctor. Your family can be with you before and after the procedure, but not during. You will be provided with discharge instructions before you go home.