About the disease
Pulmonary valve stenosis is a deformity of the pulmonary valve, when it slows its blood flow. The pulmonary valve is responsible for the supply of blood to the lungs. In most cases, this disease develops even before a child's birth. According to the American website MedScape.com, 12% cases of all congenital heart defects are pulmonary valve stenosis. In adults, 15% of heart defects are caused by this disease and it can develop in 50% of patients with congenital heart disease. It is equally common in men and women. Patients who undergo surgery have a favorable prognosis, with 96% of patients surviving and having normal life expectancy.
In most cases, this disease develops if the valve did not form in the right way during fetal development. Usually it occurs either because of a genetic predisposition or adverse environmental conditions that affected a woman during her pregnancy. Smoking and consumption of alcohol by a mother can also contribute to the development of a congenital heart defect in her baby.
In rare cases, however, pulmonary valve stenosis can occur during a person’s lifetime. Infectious diseases such as rheumatic fever or carcinoid syndrome can damage heart valves and cause pulmonary valve stenosis.
Symptoms
- Heart murmurs (an abnormal whooshing sound heard using a stethoscope, caused by turbulent blood flow)
- Pain in the chest, sometimes in the lungs and heart
- Frequent loss of consciousness
- Shortness of breath after moderate physical exercise
- Dizziness
- Fatigue
Diagnosis
Pulmonary valve stenosis is in most cases diagnosed when a doctor listens to a patient’s heart murmur. Modern diagnostic methods include:
- Echocardiography, which generates sound waves that are produced by the patient's heart. It gives the doctor information about the condition of the pulmonary valve and the severity of its narrowing.
- An Electrocardiogram, which uses electrodes that are placed on the patient's chest. These electrodes can estimate the heart’s activity and determine whether the wall of the valve has thickened (this is an indicator of stenosis).
Treatment
- Pulmonary valve repair is a type of heart surgery where the surgeon implants a valve ring, which widens the valve and prevents it from narrowing again. If there is any sign of valve leakage, which can happen if there is an insufficient blood supply, the surgeon can also insert a ring annuloplasty.
- Pulmonary valve balloon valvuloplasty is the dilation of a valve by a catheter with a balloon attached to it. A catheter is a tube which is inserted into the artery close to the groin. The catheter is then fed through to the heart with the help of special x-rays. In its turn, the balloon widens the narrowed artery. After completing this procedure, the surgeon stitches the groin area.
- Pulmonary valve replacement is performed if the valve cannot be repaired due to the disease progressing to a severe stage. The valve can be replaced with either bioprosthetic tissue or a mechanical valve. Tissue from animals such as a pig or cow can be used for this purpose. A mechanical valve is more durable than bioprosthetic tissue, but after this surgery you will need to take anticoagulation drugs to prevent formation of blood clots. You may also need to be checked by a cardiologist on a regular basis, to assess the condition of the new valve.
Valve replacement is usually used if there is a high risk of heart failure in the future. It is recommended for both men and for women. This procedure can be performed during open-heart surgery and is less invasive than catheterisation. After this procedure, the patient will usually need to stay overnight in hospital but will probably be discharged the following day.
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