Asymptomatic adults with mild/moderate isolated native pulmonary valve stenosis are in need of treatment... but not the kind you are thinking of!

As new treatment strategies are developed which outperform previous approaches in terms of safety, efficacy and long-term results, a reappraisal of old therapeutic dogmas is warranted, including lowering the threshold for intervention. Pulmonary valvuloplasty was introduced in 1982 to treat children and adults with significant isolated pulmonary valve stenosis (PS) and provided a very reliable tool to treat the problem avoiding cardiac surgery, with very good long-term results in terms of reinterventions as well as functional outcomes.1 2 Besides the neonate with critical PS, the same technique has been used to treat older children and adults with isolated PS. In these latter patient groups, the physiopathological mainstay behind the recommendation for treatment is that significant PS (defined as a Doppler velocity >4.0 m/s) creates such a significant afterload resistance and right ventricular (RV) hypertension that the RV is not able to increase stroke volume during...
Source: Heart - Category: Cardiology Authors: Tags: Congenital heart disease, Drugs: cardiovascular system, Hypertension, Interventional cardiology, Right sided valvular heart disease Editorials Source Type: research