Pulmonary Valve

 

Anatomy

The pulmonary valve is a tricuspid, semilunar valve that is similar in construction and size to the aortic valve. The valve has a right (R) -, a left (L) – and an anterior cusp (A). The pulmonary valve has a slightly more left, anterior and superior position to the aortic valve.

Pulmonary regurgitation

Pulmonary regurgitation (PR) is a volume load for the RV. Important regurgitation will lead to RV dilation. This volume load the RV will endure long but eventually the RV will fail.

 

Causes of PR
Physiologic Congenital Acquired
PR is found in 40-80% of people incorrectly constructed valve cusp(s)  As a result of pulmonary hypertension.
Absence or partial absense of a valve cusp By balloon dilatation of the PV in correction of pulmonary stenosis
Carcinoid
Endocarditis

 

Quantification of PR
Parameter Mild Moderate Severe
RV dimension normal normal / dilated dilated
Density CW signal weak dens  dens
Contour CW signal blunt variable steep
Systolic flow in pulmonary artery slightly decreased  slightly decreased  decreased 
Color doppler signal narrow jet, below pulmonary valve level wide jet far reaching in RV wide retrograde jet partly outgoing of pulmonary branches

 

 

Pulmonary stenosis

Pulmonary stenosis is very rare.

 

Causes of PS
Congenital Acquired
Tetralogy van Fallot Rheumatic fever
Tumor

 

Quantification of PS
Parameter Mild Moderate Severe
PGmax (mmHg) < 36  36 - 64 > 64
Vmax (m/s) < 3  3 - 4 > 4

 

 

 

Pane D

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