Balloon valvuloplasty is a percutaneous technique that has transformed the lives of thousands of
patients disabled by valvular stenosis. However, it is not a panacea for all stenoses and the key to success is in
patient selection. Balloon valvuloplasty works best in valves with predominately commissural fusion and little in
the way of leaflet thickening or calcification. Young patients with congenital bicuspid aortic or congenital
pulmonary valvular stenosis, or any valve with early rheumatic stenosis often have mobile leaflets with
commissural fusion. These patients enjoy excellent results from valvuloplasty with extended periods of freedom
from re-intervention including surgery [1-5]. Once the valve becomes heavily thickened and calcified, regardless
of the original aetiology, not only are the benefits of valvuloplasty reduced, but the risks are also higher. This
chapter aims to explain the details behind valvuloplasty of the aortic, mitral and pulmonary valves.
