Pulmonary valve disease

1. PULMONARY VALVE DISEASES
H. SYED ALI AFRIN
DEPT OF CCT

2. • Pulmonary valve disease is a condition in which the
lung (pulmonary valve ) located between your heart's
lower right chamber (right ventricle) and the artery
that delivers blood to the lungs (pulmonary artery)
doesn't work properly.
• The condition can interrupt blood flow from your
heart to your lungs.
• Many types of pulmonary valve disease are due to
heart conditions present at birth (congenital heart
defects). Treatment depends on the type and severity
of pulmonary valve disease.

4. Pulmonary stenosis
Pulmonary Atresia

5. PULMONARY VALVE STENOSIS
• Narrowing of the pulmonary valve reduces the blood flow
from the heart to the pulmonary artery and lungs.
TYPES
• MILD PS
• MODERATE PS
• SEVERE PS

6. Classification
• Valvular PS – most common
• Dome shaped ,narrow opening
• Thick leaflets- dysplastic valve
Causes
Occurs along with CHD such as
TOF
C-TGA
GENETIC SYNDROME – NOONAN’S SYNDROME

7. CLASSIFICATION
• Subvalvular stenosis
Muscle under the PV is thickened
• Supravalvular stenosis
• NARROWING OF THE PULMONARY ARTERY
ABOVE THE PULMONARY VALVE
• CAUSE
WILLIAM’S / ALAGILLE SYNDROME

8. PATHOPHYSIOLOGY
• NARROWING OF PULMONARY VALVE AREA
• OBSTRUCS FLOW TO PA
• INCREASES PRE LOAD
• RESULTS IN RVH

10. SIGNS AND SYMPTOMS
•A whooshing sound (murmur) that can be heard with a
stethoscope
•Fatigue
•Shortness of breath, especially during activity
•Chest pain
•Loss of consciousness (fainting)
•Babies with pulmonary valve stenosis and other congenital heart
defects may appear blue (cyanotic).

11. • Some patienis with mild pulmonary valve stenosis don't
notice any symptoms and may only require occasional doctor's
checkups.
• Moderate and severe pulmonary valve stenosis may
require a procedure to repair or replace the valve

12. Pulmonary valve regurgitation
•The flaps (leaflets) of the pulmonary valve don't
close tightly, causing blood to leak backward into the
right ventricle.
•The most common causes for a leaky pulmonary valve
is pulmonary hypertension.
•Less common causes are:
•Infective endocarditis
•Complications after surgery to repair TOF
•Carcinoid syndrome
•Rheumatic fever and complications after catheterization

13. Types
• Mild pulmonary regurgitation
• Moderate pulmonary regurgitation
• Severe pulmonary regurgitation

15. Clinical Manifestation
• Often asymptomatic
• Dyspnea on exertion
• Lethargy
• Peripheral edema
• Abdominal pain
• Thrill/murmur in pulmonary area

16. Investigation
• History and physical examination
• ECG: RVH
• CXR : ENLARGED PULMONARY ARTERIES AND
RIGHT VENTRICLE
• ECHOCARDIOGRAM: image may show rv
dilatation and hypertrophy
Abnormal septal motion if rv volume overload

17. Treatment (pv repair )
• Ring annuloplasty: To repair a leaking valve,
the surgeon sews a ring (made of metal, cloth
or tissue) around the valve to tighten it.
• Commissurotomy: The surgeon loosens a
valve with stenosis.
• Valve flap repair: The surgeon alters your
pulmonary valve flaps by trimming, patching,
shaping or rebuilding them so that they close
tightly.

18. Treatment
Pulmonary valve replacement
• Mechanical valve: A man-made valve can last as
long as 30 years. To prevent blood clots that may
accompany a mechanical valve, you doctor may
prescribe blood-thinning medications.
• Biological valve: The replacement valve is made
from cow, pig or human heart tissue. These valves
last 10 to 20 years.