In which condition should balloon valvuloplasty never be performed?

Balloon valvuloplasty is a minimally invasive procedure that can be effective in treating certain types of valvular stenosis. However, it is contraindicated in specific situations due to the nature of the condition and the characteristics of the valve involved.

In the case of aortic stenosis, particularly in adults, balloon valvuloplasty is not typically performed because it often leads to a poor long-term outcome. The aortic valve is usually calcified in older patients, and balloon dilation does not effectively address the calcifications. Instead, it can result in complications such as aortic regurgitation and may not provide significant symptomatic relief. Surgical intervention, such as aortic valve replacement, is generally the preferred treatment for aortic stenosis in these patients.

In contrast, procedures like balloon valvuloplasty can be beneficial for mitral, tricuspid, and pulmonary stenosis, especially in cases where the stenosis is due to rheumatic fever or in younger patients with less calcified valves. Therefore, understanding the structural characteristics of the valve involved and the population being treated is crucial in determining the appropriateness of balloon valvuloplasty as a treatment option.