There is a vessel in heart that is known as Pulmonary arterythat suppliesblood to both lungs for purification of blood. Whenever there is narrowing in this vessel, it is known as pulmonary stenosis.
Narrowing can happen either at the level of valve, or below or above the valve.
Most commonly seen narrowing in children is at the level of pulmonary valve known as valvularpulmonary stenosis. Other varieties of pulmonary stenosis are known as subvalvular or supravalvular pulmonary stenosis.
When there is severe narrowing especially at the level of pulmonary valve, it is known as critical pulmonary stenosis. Generally seen in newborns and babies may be in shock like state and is dependent on duct for survival.
Symptoms due to pulmonary stenosis depends on severity and type of stenosis or narrowing.
In mild pulmonary stenosis: children do not show any symptoms and got noticed by a pediatrician on hearing an abnormal sound on examination.
In severe pulmonary stenosis: children show signs of easy fatigue, loss of consciousness (syncope) and in later stages with shortness of breath (dyspnea due to right heart failure).
Pulmonary stenosis can be easily diagnosed by doing PEDIATRIC ECHOCARDIOGRAPHY.
Treatment of choice in pulmonary stenosis depends on type and severity of pulmonary stenosis.
- Valvular pulmonary stenosis: In mild to moderate valvular obstruction: child needs to be on regular follow-up.
In severe valvular obstruction:child needs to undergo early ballooning of pulmonary valve for relieving the narrowing at the valve known as “Balloon Pulmonary Valvuloplasty”(BPV).
- In sub-valvular and supra-valvular pulmonary stenosis: treatment of choice is by doing open heart surgery as ballooning in these situations is not helpful.
No medicine can cure the pulmonary stenosis.
After ballooning:one month then 3, 6, 12 months after the procedure.
After surgery: after 3 days for wound dressing, then 1, 3, 6, 12 months after surgery.
By cardiac angiography from blood vessels of thigh that are connected with the heart. Ballooning is done in a beating heart. This procedure is generally done under conscious sedation.