Pulmonary Valve

What is the pulmonary valve?

Your pulmonary valve is a heart valve that helps manage blood flow in your heart. Your pulmonary valve controls the flow of oxygen-poor blood from your heart to your lungs. You can think of this valve as the “door” between your right ventricle (lower right heart chamber) and your main pulmonary artery (also called your pulmonary trunk). Once your blood enters your main pulmonary artery, it travels through your left and right pulmonary arteries into your lungs.

Your pulmonary valve and your aortic valve are the two semilunar valves of your heart. They have this name because their leaflets (flaps) look a bit like crescent moons. Semilunar valves are the passageways between your heart’s ventricles (lower chambers) and arteries.

Pulmonic valve is another name for your pulmonary valve. You may see that term when reading about the anatomy of your heart and lungs.

What does the pulmonary valve do?

The main function of your pulmonary valve is managing the flow of oxygen-poor blood from your right ventricle into your main pulmonary artery. Here are some key points to know:

• Your pulmonary valve opens and closes with each heartbeat.
• When your right ventricle contracts (systolic phase), your pulmonary valve opens to allow blood to flow out of your heart.
• When your heart relaxes (diastolic phase), your pulmonary valve closes. This prevents blood from leaking backward into your heart.
• While your valve is closed, your right ventricle fills with blood to prepare for the next contraction.

The pulmonary valve’s function in the Ross procedure

Besides controlling blood flow out of your heart, your pulmonary valve can take on another role. It can serve as a replacement for your aortic valve when it’s become too diseased to function properly.

The Ross procedure is a surgery that helps some children and adults (under age 60) with aortic valve disease. During this complex procedure, a surgeon removes your aortic valve and replaces it with your pulmonary valve. They then give you a donor pulmonary valve. Your native pulmonary valve serves as a durable replacement for your aortic valve because it has similar anatomy and function.

Your pulmonary valve closes when your heart relaxes (diastole) and opens when your heart contracts (systole), managing blood flow from your right ventricle to your pulmonary trunk.

Where is the pulmonary valve located?

Your pulmonary valve is located inside your heart. It connects your right ventricle with your pulmonary artery. It’s situated to the right of your aortic valve, and just in front of it.

What is the structure of the pulmonary valve?

Your pulmonary valve has three leaflets (also called cusps or flaps) that open and close to control blood flow. These are your anterior cusp, left cusp and right cusp. The cusps attach to a tough, fibrous ring of connective tissue called the annulus. The cusps are just the right size to completely close the valve in the diastolic phase. This prevents backflow, also called regurgitation, of blood into your right ventricle.

What conditions and disorders affect the pulmonary valve?

Pulmonary valve disease can take many forms. Most pulmonary valve problems are congenital heart conditions, meaning you or your baby has them at birth. Less often, pulmonary valve issues develop later in life. This is usually due to other medical conditions like pulmonary hypertension.

Conditions that may affect your pulmonary valve include:

• Pulmonary atresia: With this congenital heart disease, your baby’s pulmonary valve doesn’t develop properly or tissue blocks its opening. This redirects blood to other parts of your baby’s heart, and can cause cyanosis (low oxygen levels) at birth.
• Tetralogy of Fallot: This form of congenital heart disease affects 1 in 2,500 babies born in the U.S. It involves four abnormalities in your baby’s heart. One of those abnormalities is pulmonary stenosis (narrowed pulmonary valve and main pulmonary artery). This is a serious condition that limits how much oxygen-rich blood circulates through your baby’s body. Babies with tetralogy of Fallot need surgery to correct the problem.
• Pulmonary valve stenosis: This is a narrowed valve. It’s usually congenital (present at birth), and it often affects babies who have tetralogy of Fallot. Treatment includes minimally invasive procedures to open up the valve. Some people need a valve replacement. Pulmonary stenosis rarely occurs later in life when someone is born with a normal and healthy pulmonary valve.
• Absent pulmonary valve: This congenital heart condition affects about 1 in 50,000 babies. It typically occurs in babies with tetralogy of Fallot. With this irregularity, your baby’s pulmonary valve has missing or underdeveloped leaflets (flaps). This leads to pulmonary valve stenosis (narrowing of the valve opening) plus regurgitation (leaky valve). In this case, blood leaks backward from your baby’s pulmonary trunk into their right ventricle. This condition often requires correction early in life.
• Pulmonary (pulmonic) valve regurgitation: This is a leaky valve. It’s usually due to pulmonary hypertension (in older adults) or congenital heart disease. It also affects some people who previously had surgery to repair tetralogy of Fallot. In pulmonic regurgitation, your pulmonary valve doesn’t close all the way with each heartbeat. As a result, some blood leaks backward from your pulmonary trunk into your right ventricle when your heart relaxes. Many people have a mild form of this condition. Others have moderate or severe cases that require treatment. Long-term consequences of severe regurgitation include dilation and failure of your right ventricle, and swelling and fluid overload in the form of edema.

Can you live without a pulmonary valve?

Your pulmonary valve plays a vital role in sending blood to your lungs to receive oxygen. You need a properly working valve to stay alive. Babies and children who don’t receive treatment for serious pulmonary valve conditions have a shortened life. It’s important to talk to your healthcare provider or your child’s provider about treatment options for pulmonary valve disease and life expectancy.

How can I keep my pulmonary valve healthy?

You can’t always prevent heart valve problems. But in general, a heart-healthy lifestyle can help keep your valves and heart working at their best. Tips include:

• Avoid smoking, vaping and all tobacco products. Ask your provider for resources to help you quit.
• Drink little or no alcohol.
• Eat a heart-healthy diet.
• Exercise regularly, with your provider’s guidance. Most people should aim for 150 minutes of moderate-intensity exercise (like walking) per week.
• Manage conditions like high blood pressure and high cholesterol.
• Take your medications as your provider prescribes.
• Visit a healthcare provider for yearly checkups.
• If you’re pregnant, seek appropriate prenatal and obstetric care. Such care can decrease the chances of congenital heart disease in newborns.

A note from Cleveland Clinic

Learning the anatomy of your heart can feel overwhelming. This is especially true if you or your child has been diagnosed with a heart problem. There’s a lot of information to take in. It’s not always easy to remember which valve leads where, or how a certain condition affects blood flow. But keep in mind that your healthcare provider is there to offer support and resources as you continue learning. Don’t hesitate to ask any questions that come to mind.