Pulmonary stenosis

Distinguish: valve; subvalvular and supravalvular variants of isolated pulmonary artery stenosis (ISLA).

In 10% of cases, ISLA is accompanied by a DMPP or an open oval window (Fallot triad). In valvular stenosis, the narrowing is located in the valve area, represented by the diaphragm with a central or eccentric orifice. Valve ring hypoplazirovanno.

In a one-dimensional echocardiography study (M-mode) reveal: hypertrophy of the anterior wall of the right ventricle, hypertrophy of the interventricular septum (less often), thickening of the valve cusps of the pulmonary artery, increased excursion of the tricuspid valve, prolapse of the valve of the tricuspid valve. In the study in B-mode, it is characteristic: arching the pulmonary valve valves into the output path of the right ventricle, post-stenotic dilatation of the pulmonary artery, hypertrophy of the pancreatic wall and increased echo signal from the endocardium of the pancreas. The most valuable information is provided by the Doppler EchoCG, which allows to judge the degree of pulmonary hypertension and calculate the pressure gradient at the site of stenosis. The following degrees of stenosis are distinguished: insignificant (systolic pressure gradient up to 25 mm Hg), moderate (25–50 mm Hg), marked stenosis (50–75 mm Hg.and extremely pronounced stenosis (systolic pressure gradient exceeds 75 mmHg.). As a rule, when the pressure gradient is less than 25 mmHg, this defect rarely requires any active intervention.

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