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Pulmonary Valve Stenosis — EECC MCQ

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EasyCongenital Heart Disease (Adult)Pulmonary Valve StenosisEECC

A 20-year-old man with moderate pulmonary valve stenosis (peak gradient 45 mmHg) is symptomatic with exertional dyspnoea. RV function is preserved. What is the recommended intervention?

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Correct answer: A — Percutaneous balloon pulmonary valvuloplasty

Percutaneous balloon pulmonary valvuloplasty (BPV) is the first-line intervention for congenital pulmonary valve stenosis (Class I) when the peak gradient exceeds 36 mmHg in symptomatic patients or >64 mmHg regardless of symptoms. BPV has excellent results with low complication rates and is curative in most cases of dome-shaped pulmonic stenosis. It can also be performed in dysplastic valves, though results may be less favourable. Surgical valvotomy or replacement is reserved for dysplastic valves that fail BPV, severe subvalvar or supravalvar stenosis, or when concomitant cardiac surgery is needed. The 2020 ESC ACHD Guidelines recommend BPV as the preferred approach.

Reference: ESC (2020): Guidelines for the Management of Adult Congenital Heart Disease