image by: Medigy

HWN Suggests

Pulmonary Valve

Knowledge of pulmonary valve and root anatomy is useful in understanding the spectrum of complicated conotruncal anomalies that arise from abnormal formation of the major vessels in this region. Despite the frequency of pulmonary valve diseases including congenital malformations, the pulmonary valve is the least studied valve by imaging. Along with the evolution of surgical techniques and introduction of new percutaneous procedures in recent years, imaging assessment of the pulmonary root and related pathologies has attracted more attention than before.

read full article

Previously Featured

Advancements in Percutaneous Pulmonary Valve Therapeutics: Harmony & Alterra Valves, The Next Frontier

One of the most common treatment challenges in the adult with congenital heart disease (ACHD) is management of pulmonary regurgitation, particularly in the setting of tetralogy of Fallot following transannular right ventricular outflow tract (RVOT) patch. Over time, progressive pulmonary regurgitation results in right ventricular (RV) volume overload and dilation, development of systolic and diastolic dysfunction, and risk of heart failure (HF) and atrial and/or ventricular arrhythmias, accounting for significant morbidity and increased mortality risk.

Concerned About Your Pulmonary Valve?

The pulmonary valve (sometimes referred to as the pulmonic valve) lies between the right ventricle and the pulmonary artery. The valve acts as a one-way door, so blood can flow forward through the heart easily when it opens, and then when it closes tightly, blood does not flow backwards. It controls blood flow from the right lower chamber (right ventricle) to the pulmonary artery and sends blood to the lungs to pick up oxygen.

Problem: Pulmonary Valve Regurgitation

Treatment is usually focused on the underlying cause that created the valve problem (i.e., pulmonary hypertension). The pulmonary valve very rarely needs to be replaced.

The Pulmonary Valve

The pulmonary valve consists of 3 leaflets and is similar in anatomy to the aortic valve. It is the least likely to be affected by acquired disease, and thus, most disorders are congenital. The most common hemodynamic abnormality is the congenitally narrowed domed valve of pulmonic stenosis. A minority of individuals may have a thickened or dysplastic valve. Infundibular hypertrophy may present as pulmonic stenosis with normal valve structures. Occasionally, ventricular septal defects also accompany the deformed valve. Pulmonary valvular (and subvalvular and supravalvular) lesions are diagnosed by echocardiography, pressure recordings of the right side of the heart, and right ventricular angiography.

Resources

Radiopaedia

The valve has anterior, left and right cusps, the bases of which attach around the valve orifice to a fibrous ring or annulus, forming part of the fibrous skeleton of the heart. The cusps attach to each other and the annulus at the commissures.

StatPearls

The pulmonary valve opens at the systolic phase of the cardiac cycle enabling the deoxygenated blood to be pumped from the right ventricle to the pulmonary circulation. It closes at the diastolic phase of the cardiac cycle, allowing sufficient filling of the right ventricle. The pulmonary valve has a diameter of about 20 mm.