Pulmonic 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.

Cross section of heart valves

Regurgitation

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

Quantification of pulmonary regurgitation

ParameterMildModerateSevere
RV dimensionnormalnormal / dilateddilated
Density CW signalweakdens dens
Contour CW signalbluntvariablesteep
Systolic flow in pulmonary arteryslightly decreased slightly decreased decreased
Color doppler signalnarrow jet, below pulmonary valve levelwide jet far reaching in RVwide retrograde jet partly outgoing of pulmonary branches

Causes of pulmonary regurgitation

PhysiologicCongenitalAcquired
PR is found in 40-80% of peopleincorrectly constructed valve cusp(s) As a result of pulmonary hypertension.
Absence or partial absense of a valve cuspBy balloon dilatation of the PV in correction of pulmonary stenosis
Carcinoid
Endocarditis
Severe PR

European Journal of Echocardiography (2010) 11, 223?244

Stenosis

Pulmonary stenosis is very rare.

Quantification of pulmonary stenosis

ParameterMildModerateSevere
PGmax (mmHg)< 36 36 - 64> 64
Vmax (m/s)< 3 3 - 4> 4

Causes of pulmonary stenosis

CongenitalAcquired
Tetralogy van FallotRheumatic fever
Tumor
Mild PS

J Am Soc Echocardiogr. 2009 Jan;22(1):1-23