Valvuloplasties can help elderly patients suffering from aortic stenosis

aortic-stenosis_2046663c The onward march of medical progress may sometimes be reversed when operations, regarded as obsolete, return to favour. And so it is with the treatment of aortic stenosis, or narrowing of the aortic valve, across which the heart pumps blood. Consequently, the heart must pump ever harder, causing it eventually to fail unless the narrowed valve is replaced with an artificial one.

Thirty years ago, Alain Corbier, a French surgeon, pioneered a much simpler procedure of threading a wire across the narrowed valve with a balloon attached to it. The balloon was then dilated and the wire pulled back, thus widening the diameter of the valve. It worked beautifully – until the valve inevitably narrowed again. Thus, the balloon valvuloplasty fell from favour, and surgeons went back to the replacement operation involving open-heart surgery.

The problem is that aortic stenosis is commonest among the old who do not tolerate major surgery well. Still, in an inspired piece of lateral thinking, it was pointed out they might benefit from Mr Corbier’s discarded procedure as, given their limited life expectancy, it would not matter that the valve narrowed again.

As a result, the number of balloon valvuloplasties has soared, to the advantage of many.

This week’s conundrum, originally submitted to my online clinic is particularly puzzling. It comes courtesy of Mrs P G, whose two dogs and passion for gardening keep her fit. But, beginning in October and lasting until April, she is troubled by the same pattern of symptoms.

“It starts with me losing my appetite, with intermittent queasiness,” she writes. Headache and diarrhoea follow. A battery of tests suggest nothing amiss.

Accounts of similar experiences would be appreciated.


Finally, a reader writes of the value of the common bulrush in countering bleeding. “Collect the 'fluff’ from the bulrush by rubbing your palm over it in season and store it in a jar,” she writes. This is then applied to a wound for about 10 minutes, with the result that it heals quickly without a scab.

The same remedy is widely used in China. Chinese women also take it in the form of a tea to counteract heavy menstrual bleeding. It would be fascinating to learn what the active ingredient might be.

Online clinic

The Mary Portas-style makeover of this column is an opportunity to extend its scope to include an online clinic for readers seeking advice on all types of medical problems. Those with a query should send it to to reach me by 5pm on Thursday; responses can be viewed from 10am the following morning on the Telegraph website, at

Your comments, opinions on the column and any “mystery syndromes” remain most welcome, and should be directed to Or write to Dr James LeFanu, c/o Features, Daily Telegraph, 111 Buckingham Palace Road, London SW1W 0DT.


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