[ad_1]
Pulmonary stenosis is a common congenital heart defect that narrows the pulmonary valve, causing potential heart failure. Mild cases may not require treatment, but balloon valvuloplasty is a successful nonsurgical option. Surgical options include valve replacement, which is routine and has excellent survival rates. Children may need long-term monitoring by a cardiologist. Immediate intervention is rarely necessary, but surgery may be required for related defects.
The pulmonary valve is attached to the right ventricle of the heart. It is the passage through which blood flows to reach the lungs for oxygenation. Pulmonary stenosis, a congenital heart defect, is a narrowing of the leaflets of this valve or of the valve itself. The flaps open when the right ventricle contracts and pushes blood to the lungs, but when they are stenotic, the flaps can stick together or remain partially closed. Pulmonary stenosis is the most common of the valve defects.
In many cases, pulmonic stenosis is mild and the narrowing does not significantly inhibit blood flow to the lungs. Peripheral pulmonic stenosis narrows the valve itself, but is usually mild. Such mild cases usually never require treatment, although doctors may hear a heart murmur when a stethoscope is placed on an infant’s chest. The risk with more severe forms of pulmonary stenosis is fluid backing into the heart and veins and needing the right ventricle to pump harder to move blood to the lungs. Over time, the extra work done by the heart can lead to heart failure.
The most common intervention to treat pulmonic stenosis is nonsurgical. During a cardiac catheterization, a small balloon attached to the catheter is threaded through the heart to the pulmonary valve and then inflated to reduce the narrowing. This treatment, balloon valvuloplasty, has a high degree of success. It also has the benefit of being an outpatient procedure when successful.
Sometimes balloon valvuloplasty is not enough. The procedure can be attempted to address pulmonic stenosis, but may not be successful. If pulmonic stenosis still exists, several surgical options are available. The most common option is to cut the valve out and replace it with a pig valve or a human valve from a cadaver. Unlike other transplants, rejection is not a factor in this surgery.
Children with this type of surgery generally do very well, but the valve doesn’t grow with them, so valve replacement is required at some point. With most children, this can be done about ten years after the initial valve placement. Valve replacement, although it looks serious, is considered a fairly routine procedure by most cardiothoracic surgeons.
Survival rates are excellent for valve replacement. Because of the artificial valve, cardiologists recommend antibiotics before dental procedures. Also, a child may be on long-term aspirin to prevent clots from forming in the new valve. Your child will need to see a cardiologist every year. This doctor will evaluate how well the new valve is working and will also determine when the valve may need to be replaced.
A baby with pulmonic stenosis rarely needs immediate intervention soon after birth. Pulmonic stenosis affects the heart over time, and the effect varies based on the degree of stenosis. Frequently, however, pulmonic stenosis is present with other defects, such as in Tetralogy of Fallot or hypoplastic right heart syndrome. In these cases, surgery may need to be done shortly after birth to address these other defects.
