Pulmonary Valve Disease
The pulmonary valve controls blood flow from the heart to the lungs. There are two types of pulmonary valve disease:
Pulmonary valve stenosis: The valve is narrowed or cannot open enough, restricting blood flow from the right ventricle to the lungs via the pulmonary artery, causing increased pressure in the right ventricle. The condition is usually present at birth (congenital) and may only need to be treated if severe.
Pulmonary valve regurgitation: The valve does not close completely, allowing blood to leak back into the heart before it reaches the lungs. While many adults have minimal pulmonary valve regurgitation that is harmless, some patients born with congenital heart disease, such as Tetralogy of Fallot, have severe regurgitation due to corrective surgery performed during childhood which needs to be monitored and treated.
In both conditions, the ventricle can enlarge and thicken, losing its ability to pump efficiently.
Symptoms of Pulmonary Valve Disease
Patients with pulmonary valve disease may not notice symptoms, but may need treatment before symptoms develop if the pulmonary valve is severely affected. However, when symptoms do develop, many of them are similar to those associated with heart failure:
- Shortness of breath, especially with exercise
- Chest pain (may be mild)
- Dizziness or fainting
- Bluish nails, lips or skin
- Heart murmur
- Abdominal distention
- Swelling of the feet or legs
Treating Pulmonary Valve Disease
Doctors as Houston Methodist will conduct a physical examination and evaluate your condition using one or more of the following tests:
- Electrocardiogram (EKG)
- Chest X-rays
- Cardiac magnetic resonance imaging (MRI) of the heart
- Cardiac catheterization
Treatment depends on the type of pulmonary valve disease and its severity and may involve medications such as diuretics, also known as water pills, that rid the body of excess water and relieve fluid buildup in the lungs and lower limbs.
If the pulmonary valve stenosis is severe, the condition may be treated with a minimally-invasive technique called balloon valvuloplasty. With this technique, the interventional cardiologist makes a small incision in a vein of the inner thigh and advances a balloon-tipped tube, or catheter, from that site to the heart and across the narrowed pulmonary valve. Inflation of the balloon stretches open the narrowed valve and can often completely relieve the narrowing once the balloon is deflated.
If pulmonary valve regurgitation is severe, replacement of the pulmonary valve may be necessary even before symptoms arise. While some patients may need open heart surgery to replace the valve, cardiologists at Houston Methodist have successfully replaced the pulmonary valve using the Melody Valve via a catheter placed through a small incision in the inner thigh.