This leaflet aims to give you information about the congenital heart condition pulmonary stenosis and its potential treatment options.
Pulmonary Stenosis
In this condition the valve between the right sided pumping chamber of the heart and the lung arteries (pulmonary valve) is narrowed.
The muscle of the right sided pumping chamber (right ventricle) has to work harder than normal to pump blood through the narrow valve and the muscle can become thickened. In most cases it is not a serious problem and needs no treatment but if the narrowing is very severe and the heart cannot pump normally, this may require treatment.


Treatment – Balloon Valvuloplasty
If the valve is severely narrowed, treatment may be needed, which is usually keyhole treatment rather than open heart surgery. This is done under general anaesthetic and involves passing a long tube with a collapsed balloon on the end of it (a balloon catheter) into the vein at the top of the leg and feeding it into the heart and across the narrow valve. Using X-ray pictures, the balloon is positioned in the narrow valve and is blown up, stretching the valve open. This is usually a very effective form of treatment and is very low risk. Usually only one night’s stay in hospital is necessary. Sometimes if the narrowing is only partly relieved by the balloon it is worth repeating the procedure at a later date.
Surgery
Sometimes the pulmonary valve cannot be stretched open using a balloon and open heart surgery will be needed. This involves opening the chest through the breast bone and the function of the heart and lungs is taken over by a machine. The surgeon can open the heart and cut the narrow valve open.
There is a very small risk of death (less than 1 in 100) and a very small risk of major complications such as brain damage (less than 1 in 100). Other complications such as fluid collecting around the heart or lungs can occur after the operation but these are very rarely serious.
After the operation you would need to stay in hospital for about 5-7 days, although a longer stay might be necessary if there are any complications.
Monitoring
If you have not needed any treatment by the time you become an adult you are unlikely to need treatment, but in rare cases the valve can become narrower in later adult life so it is important to still come to your follow ups. Patients who have a good result from balloon stretching of the valve or surgery usually do not need any further treatment.
Even after a good result from keyhole treatment or surgery, there is a small chance that problems may occur in the future so we still recommend follow up in the specialist clinic from time to time.
Lifestyle issues
You should not be restricted by your heart condition, and we would encourage you to follow an active lifestyle to maintain your health.
Pulmonary stenosis is not usually an issue in pregnancy but you should speak to your cardiologist or specialist nurses before becoming pregnant. You can use any form of contraception you wish with pulmonary stenosis unless there are other issues present. Speak to the specialist nurses for further advice. The chance of having a child born with a heart problem is slightly higher than normal because you have a heart problem yourself. We can offer a specialised scan of your unborn baby’s heart at 18-20 weeks, which can detect major abnormalities of the heart.
Good dental hygiene is important, to prevent endocarditis (an infection within the heart). It is important to visit the dentist regularly.
Please ask your doctor or nurse for more information. Due to the increased risk of infection we would also advise against body piercing and tattoos.
Pulmonary Stenosis – YouTube transcript
This video explains the congenital heart condition atrial septal defect and how it is treated with open heart surgery you may wish to view our video on normal heart function before viewing this blood from the body returns to the part of the heart called the right atrium blood then flows to the right ventricle from where it is pumped to the lungs via the pulmonary artery blood from the lungs returns to the part of the heart called the left atrium from where it flows to the left ventricle which is the part of the heart that pumps blood to the body via the aorta the right atrium and left atrium are divided by the atrial septum a hole in the atrial septum is called an atrial septal defect or asd when an asd is present some of the blood that should flow from the left atrium to the left ventricle passes through the asd to the right atrium and to the right ventricle pulmonary artery and lungs this means that more blood flows through the right side of the heart to the lungs than flows through the left side of the heart to the body this extra blood can cause the right side of the heart to enlarge the impact of an asd largely depends on its size at one end of the spectrum a large asd results in a large amount of extra blood flow through the right side of the heart to the lungs and may cause problems such as breathlessness and abnormal heart rhythms if larger asds are left untreated over a long period of time the extra blood flow can cause permanent damage to the right side of the heart and the arteries of the lungs at the other end of the spectrum when an asd is small there may only be a very small amount of extra blood flow through the right side of the heart and lungs such that the right side of the heart does not become enlarged these smaller asds often require no treatment but may require observation over time an atrial septal defect can be closed in one of two ways either with open heart surgery or in a keyhole procedure many asds are suitable for treatment via the keyhole procedure but some require open heart surgery here we explain the open heart surgery technique but we have a separate video explaining the keyhole procedure surgery involves either directly stitching up the hole or sewing in a patch of material over the hole preventing blood flowing through it and allowing the enlarged heart to reduce in size once an asd has been closed the right side of the heart becomes smaller it may return to a completely normal size but doesn’t always especially if a larger hole is not closed until later in life.
Pulmonary Stenosis – YouTube
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