Pulmonary valve disease is dysfunction of the valve between the right ventricle and the pulmonary artery. The two main forms are pulmonary stenosis and pulmonary regurgitation.
This page provides a more clinically detailed overview of treatment options, especially balloon valvuloplasty and, when indicated, pulmonary valve replacement/implantation.
What is Pulmonary Valve Disease?#
The pulmonary valve regulates blood flow from the right ventricle to the pulmonary artery. In valve disease, this function is impaired and creates additional burden on the right heart.
Types of Pulmonary Valve Disease:
- Pulmonary stenosis
- Pulmonary regurgitation
- Combined pulmonary valve disease
Pulmonary Stenosis#
Causes#
- Congenital (most common)
- Rheumatic disease (rare)
- Carcinoid syndrome
- Tumor
Symptoms#
- Shortness of breath
- Fatigue
- Exercise intolerance
- Syncope (in severe cases)
- Cyanosis (in advanced cases)
Grading#
| Grade | Peak Gradient |
|---|---|
| Mild | <36 mmHg |
| Moderate | 36-64 mmHg |
| Severe | >64 mmHg |
Pulmonary Regurgitation#
Causes#
- Pulmonary hypertension
- Endocarditis
- Carcinoid syndrome
- Post-surgical (Tetralogy of Fallot)
- Congenital
Symptoms#
- Usually asymptomatic
- Right heart failure signs (advanced stage)
- Exercise intolerance
Grading#
- Mild: Narrow jet width
- Moderate: Moderate jet width
- Severe: Wide jet, right ventricular dilation
Pulmonary Valve Disease Diagnosis#
Physical Examination#
- Systolic ejection murmur (stenosis)
- Diastolic murmur (regurgitation)
- Right ventricular heave
Imaging#
- Transthoracic echocardiography
- Cardiac MRI
- Cardiac CT
- Right heart catheterization
Pulmonary Valve Disease Treatment#
The treatment plan is individualized based on severity, symptoms, right ventricular function, associated heart conditions, and overall procedural risk.
Pulmonary Stenosis Treatment#
Balloon Valvuloplasty:
- First-line treatment
- High success rate
- Minimally invasive
- Long-lasting effect
Surgery:
- In dysplastic valves
- If balloon fails
Pulmonary Regurgitation Treatment#
Medical Treatment:
- Right heart failure treatment
- Diuretics
Surgical/Interventional:
- Pulmonary valve replacement
- Transcatheter pulmonary valve (Melody, Sapien)
Pulmonary Valve Implantation / Replacement: When Is It Considered?#
Pulmonary valve replacement is commonly considered in settings such as:
- Severe pulmonary regurgitation with right ventricular dilation/dysfunction (often in patients with repaired congenital heart disease)
- Severe stenosis that is not suitable for balloon valvuloplasty, or residual/recurrent obstruction after prior interventions
In selected patients, transcatheter pulmonary valve implantation (TPVI) may be an alternative to surgery after careful anatomical evaluation.
Pulmonary Balloon Valvuloplasty#
Procedure Steps#
- Femoral vein access
- Right heart catheterization
- Crossing pulmonary valve
- Balloon inflation
- Gradient measurement
Success Rate#
- Over 90% success
- Long-lasting effect
- Low complication rate
Possible Risks (General)#
Risk varies by patient and anatomy. Examples include access-site bleeding/bruising, rhythm disturbances, valve injury or increased regurgitation (uncommon), and rare thromboembolic events.
Frequently Asked Questions#
Is pulmonary stenosis dangerous?
How is pulmonary balloon valvuloplasty performed?
Is pulmonary balloon valvuloplasty permanent?
Can I exercise with pulmonary valve disease?
Does pulmonary regurgitation require treatment?
Appointment and Contact#
If you would like to schedule an appointment for pulmonary valve disease evaluation:
📍 Avrasya Hospital - Beştelsiz Mah. 101. Sokak No:107, Zeytinburnu, Istanbul
📞 Phone: +90 212 665 50 50 (Ext: 4012)
This content has been prepared by Assoc. Prof. Dr. Habib Çil for general informational purposes. Please consult a cardiology specialist for definitive diagnosis and treatment.
Related Valve Treatments#
Other structural heart treatments related to pulmonary valve disease:
- Tricuspid Valve - Tricuspid valve diseases
- Balloon Valvuloplasty - Balloon valve dilation
- Echocardiography - Valve assessment
- Heart Failure - Heart failure treatment
- EKG - Electrocardiography