Pulmonary Valve Stenosis: From Diagnosis to Current Management Techniques and Future Prospects

Figures & data

Table 1 Main Available Diagnostic Methods for Evaluation of Pulmonary Valve Stenosis

	Sequences	Structures Evaluated
TTE	PSAX great vessel view Modified PLAX Subcostal view 5Ch view for RVOT	PV morphology RV morphology and dimension Transvalvular gradient
TOE	ME RV inflow-outflow view UE esophageal (50°–70°) view TG inflow-outflow view TG RV basal view Volume rendering	RVOT morphology Proximal PA morphology and dimension PV morphology
CMR	SSFP cine imaging Phase contrast Angiography of PA	PV morphology and area RV, RVOT and PA morphology and dimension Transvalvular velocity
CCT	Axial, sagittal and coronal planes MPR reconstruction for pulmonary valve Volume rendering	PV morphology RV and RVOT morphology Pulmonary tree morphology and dimension Coronary arteries origin and pathway

Abbreviations: TTE, transthoracic echocardiogram; TOE, transesophageal echocardiogram; CMR, cardiac magnetic resonance; CCT, cardiac computed tomography; PSAX, parasternal short axis; PLAX, parasternal long axis; 5Ch, five chamber; ME, mid esophageal; TG, trans-gastric; RV, right ventricle; SSFP, steady state free procession; MPR, Multi Planar Reconstruction; PV, pulmonary valve; RVOT, right ventricle output tract; PA, pulmonary artery.

Figure 1 Multimodality imaging evaluation of PS. (A) PSAX view with Color Doppler showing flow turbulence in RVOT*; (B) CW Doppler of severe PS; (C) Reduce PV opening^† on SSFP cine imaging; (D) PA trunk dilatation with flow turbulence due to Jet lesion.

Abbreviations: PSAX, parasternal short axis; RVOT, right ventricle outflow tract; CW, continuous wave; PS, pulmonary stenosis; PV, pulmonary valve; SSFP, steady state free procession; PA, pulmonary artery.

Figure 2 Flow chart for the management of patients with PS.

Abbreviation: PS, pulmonary stenosis.