Pulmonary valve stenosis belongs to defects occurring at the level of the pulmonary artery valve cusps. According to various researchers, the incidence of pulmonary stenosis among all congenital heart defects is up to 12%.
The importance of surgery for pulmonary valve stenosis
Due to the obstructed outflow, the right ventricle works with a constant overload, which quite quickly leads to an increase of its cavity and thickening of its wall. Therefore, it is necessary to carefully monitor the course of the heart disease, which often does not manifest itself obviously and has no influence on the growth, development, and behavior of the child. At some point, perhaps during the first 10 years, the question of surgery will arise. It will arise when the pressure difference between the right ventricle and the pulmonary artery reaches a certain level (it is measured by ultrasound scan quite accurately).
Surgery consists of dissection of the fused cusps. However, if such heart defects have been present for a long time (several years), sometimes it will be necessary to dissect the muscle bundles formed due to thickening of the right ventricular wall, or even to dissect the pulmonary artery ring (the place where the cusps attach) and sew a small patch there, thus widening the ventricular outflow tract.
In any case, pulmonary valve stenosis surgery shouldn’t be postponed. Today you can undergo minimally invasive endovascular valve dilation without surgery, but the choice of method depends entirely on the specific health condition of a patient.
However, when the narrowing is eliminated by a simple dissection of the merged cusps, their normal structure is not restored. Over time, the patient may develop signs of valve insufficiency, because the valve passes blood well, but its leaflets do not close normally. Pulmonary valve insufficiency is much less “aggressive” in its clinical manifestations than aortic valve insufficiency, but sometimes, even many years after the first surgery, the question about the pulmonary valve replacement with a prosthesis may arise.
Indications for surgery
In patients with pulmonary valve stenosis indications for surgery are strictly individual, and it can be recommended only when all methods of conservative therapy have been exhausted and heart failure is aggravated. The risk of such surgery is often low, and the results are quite good.
The indication for surgical treatment is a severe pulmonary valve stenosis with systolic pressure gradient over 50 mm Hg. In the presence of valve leaflets dysplasia, open surgical correction of the defect is often indicated, in other cases endovascular treatment is possible.
In most cases the endovascular intervention is performed under local anesthesia, except for newborns in critical condition, in whom the surgery is carried out under general anesthesia. The essence of the operation is that after puncturing the femoral vein a catheter is inserted into the cavity of the right ventricle. After that it is moved to the heart, through the pulmonary valve into the distal parts of the pulmonary artery. A balloon catheter or artificial valve is subsequently guided through the guidewire and a valvuloplasty is performed. When carried out in specialized hospitals, the operation is not connected with lethal outcomes and complications. The hospital stay duration is no longer than 1-3 days.
Undergoing pulmonary valve stenosis surgery abroad during the COVID-19 pandemic
The COVID-19 pandemic has affected the sphere of medical tourism significantly. However, the number of people who want to go abroad for treatment hasn’t decreased at all.
Since certain interventions can only be carried out in the hospitals abroad, the idea of undergoing treatment in the foreign country is worth pursuing. And Booking Health can help you with that. The company provides organizational services for those who want to undergo pulmonary valve stenosis surgery as soon as possible. You and your child can concentrate on the treatment and recovery, while Booking Health deals with everything else, including the time-consuming process of getting a medical visa during a lockdown.
Don’t hesitate to contact Booking Health for any information or assistance you need.
