Treatments for pulmonary valve stenosis in children

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Contact the Heart Center

The Heart Center at Boston Children's is the largest pediatric heart program in the United States. Our staff of more than 80 pediatric cardiac specialists cares for thousands of children and adults with congenital and acquired heart defects each year, from simple to complex cases. We have experience treating rare heart problems?with success rates that are among the best in the world.

Treatment options

Having identified your child's heart condition, Boston Children's Hospital can begin treating him.

Mild pulmonary stenosis generally does not require treatment. Moderate or severe stenosis is usually managed by cardiac catheterization (balloon dilation or valvuloplasty), in which:

  • A small, flexible tube (catheter) with a deflated balloon in the tip is inserted into the narrowed valve.
  • The balloon is inflated to stretch the area open.

Pulmonary valve stenosis can also be repaired by open heart surgery, though this is less common. The vast majority of abnormal pulmonary valves in infants and children are repaired through cardiac catheterization, usually on a non-emergency, scheduled basis.

Some infants who have severe pulmonary valve stenosis will need more emergent procedures and care in Boston Children's Cardiac Intensive Care Unit (CICU) prior to treatment.

Depending on the severity and variations of the defect, repair options include:

  • cardiac catheterization: balloon dilation or valvuloplasty
    • This is the most common method of repair for pulmonary valve stenosis.
    • A small, flexible tube (catheter) is inserted into a blood vessel in the groin and guided to the inside of the heart.
    • The tube has a deflated balloon in the tip.
    • When the tube is placed in the narrowed valve, the balloon is inflated to stretch the area open.
  • surgical repair surgical separation of valve leaflets that have become fused, allowing the valve leaflets to open properly
  • surgery: pulmonary valve replacement
    • Tissue valve (pig or human) may be placed in the position of the abnormal pulmonary valve.
    • Pulmonary valve replacement is reserved for cases in which other therapies have been exhausted and the valve has significant leaking.
    • Children who undergo a valve replacement will need to follow a lifelong antibiotic regimen to decrease the risk of infection.
       

About cardiac catheterization at Boston Children's

Boston Children's has pioneered interventional catheterization for many congenital heart defects.

  • It's often used at Boston Children's instead of open-heart surgery to treat congenital heart defects, including opening a stenotic pulmonary valve.
  • Boston Children's performs hundreds of cardiac catheterizations each year.
  • Boston Children's trains more specialists in performing the procedure than any other hospital in the United States.

As he grows: your child's long-term outlook

Most children will live healthy lives with normal growth, no restrictions on exercise and activities, and for females, no risks associated with pregnancy later in life.

Most people who've had congenital heart disease repair will have an ongoing relationship with their cardiologist, since they'll always be at some risk for arrhythmias (abnormal heart rhythms), infections and other problems. Your child's cardiologist will help you create a long-term care program as your baby matures into childhood, the teen years and even adulthood.

A small percentage of repaired pulmonary valves will have leakage and calcifications from the repaired valve. Patients who develop symptoms later in life can be candidates for re-intervention or valve replacement.

Coping and support

At Boston Children's, we understand that a hospital visit can be difficult, and sometimes overwhelming. So, we offer many amenities to make your child's—and your own—hospital experience as pleasant as possible. Visit The Center for Families for all you need to know about:

  • getting to Boston Children's
  • accommodations
  • navigating the hospital experience
  • resources that are available for your family

In particular, we understand that you may have a lot of questions if your child is diagnosed with pulmonary valve stenosis: How will it affect my child long term? What do we do next? We can connect you with a number of resources to help you and your family through this difficult time, including:

  • patient education: From the office visit to treatment and recovery, our nurses will be on hand to help answer any questions you may have—How long before my child is fully recovered? What precautions should we take? We will also reach out to you by phone, continuing the care and support you received while at Boston Children's.
  • parent-to-parent: Want to talk with someone whose child has been treated for pulmonary stenosis? We can often put you in touch with other families who've been through the same experience that you and your child are facing, and who will share their stories.
  • faith-based support: If you're in need of spiritual support, we'll connect you with the Boston Children's chaplaincy. Our program includes nearly a dozen clergy— representing Protestant, Jewish, Muslim, Roman Catholic, and other faith traditions—who will listen to you, pray with you and help you observe your own faith practices during your hospital experience.
  • social work: Our social workers and mental health clinicians have helped many families in your situation. We can offer counseling and assistance with issues such as coping with your child's diagnosis, stresses relating to coping with illness and dealing with financial difficulties.
  • As your child reaches adulthood, you'll want him to know about our Boston Adult Congenital Heart and Pulmonary Hypertension Service (BACH). Children's is a founding institution of BACH—an international center for excellence, providing long-term inpatient and outpatient care and advanced therapeutic options as needed for congenital heart disease patients as they reach and progress through adulthood.

To find out more, visit the Family resources page of Boston Children's For Patients and Families website.

You'll be comforted to know …

… that Boston Children's pioneered interventional catheterization for many congenital heart defects. Catheterization is often used at Boston Children's instead of open-heart surgery to treat congenital heart defects. We perform hundreds of cardiac catheterizations each year, and we train more specialists in performing the procedure than any other hospital in the United States.

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital 300 Longwood Avenue, Boston, MA 02115 617-355-6000 | 800-355-7944

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