Pulmonary Stenosis / Regurgitation

​The pulmonary valve is one of the valves that allow blood from the body to return to the lung for oxygenation. The normal pulmonary valve has three leaflets. Obstruction can be at the valve, below the valve or above the valve. The leaflets may be malformed, thus causing the pulmonary valve to become too narrow (stenotic) or leaky (regurgitant).

​Patients with mild to moderate pulmonary valve stenosis or regurgitation seldom have other associated heart condition. However if the pulmonary stenosis is severe, it may cause you to be tired and develop shortness of breath easily on slight exertion. You may also experience fast heartbeats (palpitations).

Diagnosis normally starts with a physical examination by a doctor, assessing your medical history and routine tests. Other tests recommended may include:

• Cardiac Magnetic Resonance Imaging (MRI)
• Cardiac Computed Tomography (CT)
• Electrocardiogram (ECG)
• Echocardiogram
• Cardiac catherisation

Surgical/balloon valvuloplasty intervention

If the pulmonary stenosis (also known as pulmonary valve stenosis) is severe, balloon valvuloplasty can relieve the obstruction to increase blood flow to the lungs. A special balloon tipped catheter is placed across the stenotic valve. The balloon is then inflated, stretching the valve open.

If the pulmonary valve is severely leaky, an operation is usually needed to repair or replace the malformed valve. However, if you have a previous pulmonary valve replacement, you can be a candidate for percutaneous valve replacement.

Ongoing medical therapy

If the pulmonary stenosis or regurgitation is mild to moderate, intervention may not be necessary. However there is a need for ongoing follow-up with your cardiologist to check for any abnormal heart rhythm or enlargement of the right ventricle.

Activity

In most cases, you are not required to limit your activity if your pulmonary stenosis or regurgitation is mild or moderate. However, if the pulmonary valve defect is severe, there might be need to avoid certain strenuous exercise. Please check with your cardiologist.

Prevention of Infective Endocarditis (IE)

The incident of IE in congenital patient is higher than general population. Therefore it is important for congenital patient to maintain good oral, dental and skin hygiene as primary prevention. Cosmetic tattooing and piercing are discouraged due to the risk of IE. Antibiotic prophylaxis is considered for patient at highest risk for IE before surgery and dental procedures. Please discuss with your congenital team for the latest update on the antibiotic prophylaxis.

Family planning and pregnancy

If the pulmonary stenosis or regurgitation is mild to moderate, you are more likely to handle pregnancy well. However, pregnant women with severe pulmonary valve defect may have higher risk and require closer monitoring by her cardiologist during her pregnancy.