Pulmonary valve disease refers to any disorder of your heart's pulmonary valve, which is responsible for keeping blood from your heart flowing properly to your lungs. Pulmonary valve disease can refer to a leaky valve (pulmonary regurgitation) or a narrowed valve (pulmonary stenosis). Treatment depends on the type of pulmonary valve disease you have and its severity.

  • Experience. Mayo Clinic is one of the largest and most experienced medical centers for pulmonary heart valve surgeries.
  • Continuous improvement. Mayo Clinic doctors are actively researching heart valve disease, and you may be eligible to participate in clinical trials of experimental treatments, if appropriate for your condition.
  • Time for you. Doctors at Mayo take time to listen to your problem, explain your options and answer your questions.

About

The pulmonary valve acts like a one-way door from your heart's right ventricle to your lungs. Oxygen-depleted blood flows from the ventricle, through the pulmonary valve and into the lungs, where it picks up oxygen to deliver to your body.

The pulmonary valve consists of three half-moon-shaped flaps of tissue called cusps. These cusps open to allow blood to flow from your right ventricle to your lungs. Then they close so that the blood can't flow backward. If the cusps are malformed, the valve may become narrowed (pulmonary stenosis), reducing the amount of blood reaching the lungs. Or the valve may leak, allowing blood to flow back into the right ventricle (pulmonary regurgitation).

Diseases of the pulmonary valve are fairly uncommon, and most are due to defects present at birth (congenital defects). Sometimes there are no symptoms for decades, so congenital valve defects may not be diagnosed until later in life. In addition, your pulmonary valve can be damaged by infectious diseases, such as endocarditis or a rare condition called carcinoid heart disease. Pulmonary valves can also be damaged by high blood pressure within the lung's blood vessels (pulmonary hypertension).

Read more about endocarditis.

Mayo Clinic in Rochester, Minn., is ranked among the Best Hospitals for heart and heart surgery by U.S. News & World Report.

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Experienced Mayo specialists in cardiology and cardiac surgery at Mayo Clinic in Arizona coordinate the diagnosis and treatment of adults who have pulmonary valve disease.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

Experienced Mayo specialists in cardiology and cardiac surgery at Mayo Clinic in Florida coordinate the diagnosis and treatment of adults who have pulmonary valve disease.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

Experienced Mayo specialists in cardiology and cardiac surgery at Mayo Clinic in Minnesota coordinate the diagnosis and treatment of pulmonary valve disease.

The Valvular Heart Disease Clinic at Mayo Clinic in Minnesota integrates the most advanced diagnostic and treatment options with a patient-centered, team approach to the treatment of heart valve disease.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

Experienced Mayo specialists in pediatric cardiology coordinate the diagnosis and treatment of pulmonary valve disease in children.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

At Mayo Clinic, an experienced team of heart care specialists work together to diagnose pulmonary valve disease. In addition to a thorough physical examination and history, diagnostic tests can help identify the type of pulmonary valve disease, its severity and the treatment needed. Tests may include:

  • Chest X-ray. A chest X-ray shows an image of your heart, lungs and blood vessels. If your heart is enlarged or its shape is abnormal, your doctor may order further tests to check for pulmonary valve disease.
  • Electrocardiogram (ECG). In this noninvasive test, a technician will place probes on your chest that record the electrical impulses that make your heart beat. An ECG records these electrical signals and can help your doctor detect irregularities in your heart's rhythm and structure. You may have an ECG while you're at rest or while exercising (stress electrocardiogram).
  • Echocardiogram. This noninvasive exam, which includes an ultrasound of your chest, shows detailed images of your heart's structure and function. Sound waves are transmitted, and their echoes are recorded with a device called a transducer that's held outside your body. A computer uses the information from the transducer to create moving images on a video monitor.
  • Transesophageal echocardiogram. If the images from a regular echocardiogram are unclear, your doctor may recommend a transesophageal ultrasound. During this exam, a flexible tube containing a small transducer, about the size of your index finger, is guided down your throat. The transducer will transmit images of your heart to a computer monitor.
  • Exercise stress test. An exercise stress test usually involves walking on a treadmill or riding a stationary bike while your heart rhythm, blood pressure and breathing are monitored. Because exercise makes your heart pump harder and faster than it does during most daily activities, an exercise stress test can reveal problems within your heart that might not be noticeable otherwise.
  • Cardiac catheterization. In this test, a short tube (sheath) is inserted into a vein or artery in your leg (groin) or arm. A hollow, flexible and longer tube (guide catheter) is then inserted into the sheath. Aided by X-ray images on a monitor, your doctor threads the guide catheter through that artery until it reaches your heart. The pressures in your heart chambers can be measured, and dye can be injected. The dye can be seen on an X-ray, which helps your doctor see the blood flow through your heart, blood vessels and valves to check for abnormalities.
  • Computerized tomography (CT). This test is sometimes used to evaluate the heart and pulmonary arteries. In a cardiac CT scan, you lie on a table inside a doughnut-shaped machine. An X-ray tube inside the machine rotates around your body and collects images of your heart and chest.
  • Magnetic resonance imaging (MRI). In a cardiac MRI, you lie on a table inside a long tube-like machine that produces a magnetic field. The magnetic field aligns atomic particles in some of your cells. When radio waves are broadcast toward these aligned particles, they produce signals that vary according to the type of tissue they are. Images of your heart are created from these signals, which your doctor will look at to help determine the cause of your heart condition.

Read more about chest X-ray, ECG, echocardiogram, exercise or stress test, cardiac catheterization, CT scan, and MRI.

In some cases, pulmonary valve disease can be monitored or its symptoms treated with medication. But if the stenosis or regurgitation is severe, you may need repair or replacement of your pulmonary valve. Mayo Clinic is one of the country's leading medical centers for heart valve surgery.

Mayo heart specialists consider your pulmonary valve disease, its severity, your symptoms and your input when they create a customized treatment plan. Treatment for pulmonary valve disease may include:

Careful monitoring

If you have no symptoms and tests reveal mild or moderate disease, your doctor may recommend regular checkups to monitor for any changes in your pulmonary heart valve. You may also need to take antibiotics prior to any dental or surgical procedures in order to avoid contracting bacterial endocarditis, a serious infection of the heart and its valves.

Medications

Your doctor may prescribe medications to control shortness of breath, reduce your heart's workload or regulate your heart's rhythm. For most people, medication alone can't slow the progression of pulmonary valve disease.

Catheter-based therapy

During cardiac catheterization, doctors thread a tube through a vein in your leg and up to your heart. Then, they insert instruments through the tube to perform procedures on the heart. Mayo Clinic doctors offer procedures such as balloon valvuloplasty or percutaneous pulmonary valve therapy to repair the pulmonary valve. These procedures are available to select patients who fit the criteria for this type of treatment.

Surgery

Heart valve repair can involve separating fused valve cusps, sewing torn cusps or reshaping parts of the valve to allow it to close tightly. More commonly, surgeons replace the pulmonary valve with an artificial valve, which may need to be replaced again after a number of years.

Mayo Clinic heart doctors have developed innovative surgical techniques to treat heart valve disease, including using minimally invasive surgery. During minimally invasive surgery, Mayo surgeons repair or replace the valve through small incisions.

At Mayo Clinic, your team of doctors will discuss options for heart surgery with you in detail, taking into consideration your disease, symptoms, age and any risk factors.

Read more about endocarditis.

Mayo Clinic doctors are actively seeking improved diagnostic tools and better treatment for all types of heart valve disease. You may be eligible to participate in clinical trials of experimental treatments, if appropriate for your condition.

Publications

See a list of publications by Mayo Clinic doctors on pulmonary valve disease on PubMed, a service of the National Library of Medicine.

Jan. 30, 2013