Pulmonary Valve Disease Care

If you have pulmonary valve disease, chances are you were born with it (it’s congenital). It’s typically diagnosed and treated in early childhood. Pulmonary valve disease that develops later in life is rare but can be the result of complications from a previous heart valve surgery or from pulmonary hypertension. It can also result from an infection from another illness, such as endocarditis, inflammatory disorders or rheumatic fever.

The two most common types of pulmonary valve disease are stenosis (when the opening to your valve gets narrow or stiff) and regurgitation (when your valve doesn’t close completely and leaks).

The symptoms of pulmonary valve disease can be subtle. You might be very tired, have swollen ankles or feel like your heart is skipping a beat. If the disease is farther along, you might have chest pain, shortness of breath or feel dizzy. You can also have heart valve disease for a long time and not feel any symptoms at all.

What to expect at your first appointment

At your first appointment, your healthcare provider will want to know your medical history and if any of your family members have heart conditions. They’ll ask if you have any symptoms and how bad they are. Your provider may also listen to your heart through a stethoscope. If your provider hears a murmur (unusual whooshing sounds), that might mean there’s a blood flow problem in one of your valves. Not all murmurs are something to worry about, but it’s important to find out what’s causing the murmur and to check on it over time.

If you have a heart murmur and/or have any of the symptoms mentioned above, your provider may order one or more of these tests to confirm a diagnosis:

• Electrocardiogram (EKG): Your provider will put sticky electrode pads on your chest, arms and legs to measure your heart’s electrical activity.
• Echocardiogram (Echo): This test uses high-frequency sound waves (ultrasound) from a handheld wand on your chest to take pictures of your heart’s valves and chambers. This will show how well your heart’s pumping.
• CT Scan: This test takes three-dimensional pictures of your heart to show how blood is flowing through your heart and blood vessels.
• MRI: An MRI uses powerful magnets and radio waves to take moving pictures of your heart as it’s pumping to see if there’s unusual blood flow through your heart.
• Cardiac catheterization (cardiac cath or angiogram): Your provider will put a small, flexible tube (catheter) into your leg or arm and pass it through a blood vessel to the inside of your heart to see how it’s working.
• Chest X-ray: A chest X-ray uses a focused beam of radiation to look at your heart.
• Exercise stress test: Your provider will have you walk on a treadmill or pedal a stationary bike while you’re hooked up to an EKG machine to check your heart’s activity when it’s working hard.

Meet Our Team

Our care team is made up of highly skilled, industry-leading heart specialists, including:

• Cardiologists with subspecialty training including imaging, electrophysiology, heart failure and more.
• Interventional cardiologists (specialists in minimally-invasive procedures).
• Cardiothoracic surgeons.
• Anesthesiologists.
• A nursing team.

Your treatment will depend on the type of pulmonary valve disease you have, how bad it is, your age, medical history and your family’s medical history. It’ll also depend on your goals — what you want to get out of treatment. If you don’t have any symptoms or your symptoms are mild, your provider may just keep an eye your condition with regular checkups.

They may also prescribe medications, like diuretics (water pills) and anticoagulants (blood thinners). Medications like these can relieve mild symptoms, help your heart pump better and lessen the chance of more valve damage.

If your valve is badly damaged, it might need to be repaired or replaced. Depending on your condition, your provider may recommend:

Transcatheter pulmonary valve replacement (TPVR)

Our interventional cardiologists use this minimally invasive procedure whenever possible. With TPVR, your provider replaces your pulmonary valve by putting a small tube (catheter) through a small incision (cut) into a vein in your groin or neck, instead of making a larger incision across your chest, as in traditional open heart surgery. Cleveland Clinic interventional cardiologists have been doing TPVR procedures on adults and children — often with complex medical needs — since 2010, with results that are among the best in the world. Your provider can tell you if TPVR will work for you.

Surgical pulmonary valve replacement (SPVR)

If TPVR isn’t an option for you, your provider may recommend surgery to repair or replace your pulmonary valve. Whenever possible your surgeon will use minimally invasive techniques (smaller cuts). Your provider will tell you if traditional open heart surgery (larger cut across your chest) is necessary. Our highly skilled surgeons have done thousands of both minimally invasive and open heart surgeries with results that are among the best in the world.

Hybrid pulmonary valve replacement

If TPVR isn’t an option for you, and traditional surgery puts you at high risk, your provider may recommend a hybrid or combination procedure. Working with an interventional cardiologist, your surgeon will use a minimally invasive approach to avoid going on the bypass machine. This will minimize the risks of traditional open heart surgery that are associated with cardiopulmonary bypass runs.

Traveling for Heart Care at Cleveland Clinic

We know that traveling for any kind of healthcare can be stressful and intimidating. If you’re coming to us from another city, state or even another country, we’re here to help make things as easy and convenient as possible for you. From knowing where to stay and where to eat, how to get to and from the airport, shop, or just find your way around any of our hospitals, we’re here for you.

If you’re an international patient, our experienced and compassionate Global Patient Services (GPS) team will help you navigate the Cleveland Clinic health system. They’ll connect you with the healthcare providers you need, help make appointments, provide language translation services and coordinate follow-up care when you return home.

Taking the Next Step

Heart valve disease can be a scary, overwhelming diagnosis. And if it comes as a surprise, you might be left wondering what’s next. Rest assured, you’re in the best, most capable and confident hands at Cleveland Clinic. We are ready to take you from diagnosis to treatment and beyond.