What is the average life expectancy for pulmonary artery stenosis? Peripheral stenosis of the pulmonary artery. The reasons

Isolated stenosis pulmonary artery occurs in 2.5-2.9% (Abbott, 1936; Galus, 1953) of cases of congenital heart anomalies. In 10% of cases, it is combined with other heart defects (J. Grinevetsky, J. Moll, T. Stasinski, 1956). Isolated stenosis of the pulmonary artery refers to congenital malformations of the "pale", aciano type.

The pulmonary artery narrows at the level of the valves (valvular stenosis) or under the valves, in the region of the right ventricular outflow tract - subvalvular, or infundibular, stenosis. In 80% of cases, valvular stenosis occurs and in 20% - subvalvular stenosis (A. A. Vishnevsky, N. K. Galankin and S. Sh. Kharnas, 1962).

Difficulty in the exit of blood from the right ventricle into the narrowed pulmonary artery leads to its hypertrophy (Fig. 14). Over time, right ventricular failure develops.

Rice. 14. Narrowing of the mouth of the pulmonary artery (scheme). 1 - narrowing of the mouth of the pulmonary artery (43% of cases - at the level of the valve of the pulmonary artery, 43% - in the area of the cone of the pulmonary artery, 14% - simultaneous narrowing in the area of the valve and the cone); 2 - dilatation and hypertrophy of the right ventricle.

During intrauterine life, even significant pulmonary artery stenosis does not create a load on the fetal circulatory system, and therefore the heart is usually of normal size at birth. After the birth of a small or medium degree stenosis often does not cause marked enlargement of the right ventricle; with significant stenosis, as a rule, there is a gradual increase in the right ventricle.

Thus, the size of the right ventricle to a certain extent serve as an indicator of the degree of narrowing of the pulmonary artery. Often there is also an increase in the right atrium.

The value of systolic pressure in the right ventricle can reach 300 mm Hg. Art. instead of the normal 25-30 mm Hg. Art.

The clinical picture of the defect is varied and depends on the degree of stenosis. Minor pulmonary stenosis proceeds favorably, often without causing subjective disorders. Such patients live to old age, maintaining full working capacity.

With an average degree of stenosis of the pulmonary artery, usually during puberty, shortness of breath occurs, which increases even with slight physical exertion, palpitations, and pains appear in the region of the heart. The child lags behind in growth and development.

Significant stenosis of the pulmonary artery already in childhood causes a gross violation of blood circulation. Shortness of breath is pronounced even at rest and increases with the slightest exertion. It is usually not accompanied by cyanosis (“white defect”), but with prolonged circulatory failure, bluish cheeks and lower extremities can be observed.

Thickening of the fingers in the form of drumsticks in these patients also usually does not develop or is mild; no polycythemia observed. The symptom of the position of the patient on his haunches is extremely rare, with a significant narrowing. The reserve capacity of the hypertrophied right heart is small, and the increase in right ventricular failure, as a rule, leads to death at a young age.

Patients with isolated narrowing of the pulmonary artery often have a cardiac hump (a consequence of right ventricular hypertrophy).

In the region of the pulmonary artery - in the second intercostal space at the left edge of the sternum - systolic trembling ("cat's purr") is determined by palpation. The heart is enlarged to the right. Auscultation reveals a rough, scraping systolic murmur along the left edge of the sternum with a maximum sound in the second intercostal space. Noise in some patients is transmitted to carotid arteries and is heard from the side of the back to the right and left of the spine. Such irradiation of noise is caused by transition to an aorta and distribution on it (S. Sh. Kharnas, 1962). Valvular stenosis is characterized by the absence or significant weakening of the second tone above the pulmonary valve. With infundibular stenosis, the second tone is preserved. Arterial pressure and pulse have no characteristic features.

An x-ray shows enlargement of the right ventricle. The top of the heart is rounded. The arc of the pulmonary artery with valvular stenosis does not pulsate. Often there is a significant post-stenotic aneurysmal expansion of the trunk of the pulmonary artery. The lung fields are light, the vascular pattern is poor. The roots of the lungs are not expanded.

The electrocardiogram shows signs of overstrain of the right ventricle, deviation of the electrical axis of the heart to the right.

On phonocardiograms over the pulmonary artery, a spindle-shaped murmur begins with a slight pause after the first tone; reaches the second tone and ends before the beginning of its pulmonary part. The second tone is bifurcated. Systolic murmur may radiate to the aorta, Botkin's point, to a lesser extent to the apex of the heart.

When diagnosing isolated stenosis of the pulmonary artery, one should also take into account possible concomitant anomalies in the development of the heart, such as septal defects, open ductus arteriosus, etc.

The prognosis depends on the degree of stenosis and severity clinical symptoms. Patients are predisposed to inflammatory! diseases respiratory organs and bacterial endocarditis.

Pronounced stenosis early causes the development of right ventricular failure and sudden death.

The presence of severe symptoms of the defect and its progressive course serve as indications for surgical treatment.

However, given that over time, stenosis, even mild, leads to significant irreversible impairment of myocardial contractility and circulatory disorders, it is recommended to operate on patients not only with severe and moderate, but also with mild stenosis and possibly early dates(A. A. Korotkov, 1964).

Produce transventricular closed valvotomy (according to Brock), transarterial (through the pulmonary artery) according to Sellors or intracardiac surgery using cardiopulmonary bypass. According to S. Sh. Harnas (1962), mortality in the surgical treatment of valvular stenosis of the pulmonary artery is 2%, with infundibular stenosis - 5-10%.

Congenital stenosis of the pulmonary artery has long been considered a disease that is completely incompatible with pregnancy (Kraus et al.). This view is currently subject to revision.

We observed 5 pregnant women (all nulliparous) with isolated pulmonary artery stenosis (including three after surgical correction of the defect) were aged from 21 to 30 years.

Pregnancy in one of 2 patients who did not undergo surgical treatment (T., 30 years old) ended
urgent spontaneous delivery of a live baby weighing 2800 g, 51 cm long. The second patient underwent abdominal (at the 22nd week of pregnancy) with sterilization (under endotracheal anesthesia). A year after the termination of pregnancy at the Institute of Cardiovascular Surgery of the USSR Academy of Medical Sciences, she underwent pulmonary valvotomy under hypothermia and received positive result.

In one of the 3 patients who underwent heart surgery for pulmonary artery stenosis (S., 22 years old), it occurred 3 years later, in the other (L., 27 years old) - 2 years after transventricular valvotomy. The pregnancy proceeded favorably and ended with a normal term delivery. Live children were born (weight 2700 and 3400 g, length 49 and 50 cm, in a satisfactory condition).

The third patient (K., 21 years old) came to us at the 8th week of pregnancy with complaints of shortness of breath, fatigue, general weakness, interruptions in the work of the heart. The patient's condition worsened during pregnancy. She categorically refused to terminate the pregnancy. It was decided to send her to surgery. At the 12th week of pregnancy, the patient underwent a transventricular valvotomy. After the operation, the patient's condition improved. The pregnancy ended in premature birth (at 33-34 weeks). A live fetus was born weighing 1700 g, 40 cm long; the child was transferred to the Institute of Pediatrics of the USSR Academy of Medical Sciences, where he developed normally and was discharged home in a satisfactory condition, with normal weight.

Thus, only one of 5 patients with isolated pulmonary artery stenosis had a late pregnancy; (produced C-section at the 22nd week of pregnancy), the remaining women gave birth to live children (one premature).

Our experience shows that with a slight narrowing of the pulmonary artery, which occurs without a significant load on the right heart, the patient can cope with pregnancy and spontaneous childbirth. Severe narrowing of the pulmonary artery leading to right ventricular failure requires either termination of pregnancy or surgical correction of the heart defect.

Stenosis that occurs in the pulmonary artery is called a decrease in the space between the pulmonary arteries and the right ventricle of the heart, which causes interruptions in the transport of blood to the lungs. The disease can be observed in different places of the artery.

Types of illness

There are the following types of this defect:

valve. The result is stenosis of the pulmonary valve. It occurs due to problems with the original structure of the valve. Depending on the amount of damage to the valves, there are single-leaf, two-leaf and three-leaf types of the disease;
supravalvular. As a result, there is a decrease in the space between the trunk of the artery of the lungs and the space below the valve;
subvalvular. Appears as a result of excessive narrowing of the muscles in the right ventricle, which creates a barrier to the exit of blood into the artery;
peripheral. It is represented by stenoses of various localization.

It is worth noting that subvalvular, as well as valvular pulmonary stenosis, often manifests itself simultaneously with others. These include the following defects: tetralogy of Fallot, transposition of vessels and others.

Symptoms

The severity of symptoms depends on how narrowed the artery is. Often the disease manifests itself in newborns or young children, much less often in adolescents and adults.

Heart disease can be hidden, not manifesting any symptoms throughout life, or have minor manifestations that the patient can confuse with symptoms of other ailments. The defect can be accidentally detected on ultrasound of the heart. The main and most characteristic symptoms are:

fast fatiguability;
general weakness;
pain in the sternum;
rapid onset of shortness of breath during physical activity;
bluish skin tone;
periodic fainting, as well as dizziness.

Reasons for the development of the disease

The main factors that lead to the development of heart disease in children and newborns include:

the influence of genetics. If parents have a heart defect, then it can be inherited by their children;
influence of the ecological situation. Stenosis of the mouth of the pulmonary artery can develop if the mother of the child lived in a disadvantaged place during pregnancy. For example, next to factories.

Environmental factors, in turn, are divided into:

physical. Mutagens cause damage to the DNA molecule, which carries all the information about a person. This includes radiation;
chemical. These include various hazardous chemicals such as benzpyrene, phenol, alcoholic beverages and some antibiotics;
biological. This group includes viruses and various diseases, such as, or. If a mother suffers from diseases during pregnancy, then her children will have congenital pathologies.

Congenital stenosis of the mouth of the pulmonary artery can be found quite often - its frequency of occurrence is up to one tenth of all cardiac pathologies.

Complications

it serious disease may have the following health effects:

bacterial type;
(impaired blood circulation in the brain, followed by the death of its sections).

Diagnostics

Stenosis of the mouth of the pulmonary artery can be detected during examination of the patient. In children with this disease, a "heart hump" is noticeable. In addition, the doctor may identify excessive swelling of the veins in the neck. During a detailed examination, isolated pulmonary stenosis is detected due to systolic tremor. Patients suffering from an advanced form of the disease may have a huge heart. To determine if a patient has isolated pulmonary stenosis, you can use the following methods:

auscultation. It reveals a noticeable systolic murmur during the work of the heart. Most patients have an enhanced 1 tone. At the same time, it is impossible to listen to tone 2, since it is too weak. Noises can be found at the location of the left collarbone or in the area between the shoulder blades;
phonocardiogram. Here you can see the noise of the systolic type. It is auscultated on the left side of the sternum. It starts after tone 1, and tone 2 is split. Best of all noise is audible in the second part of a systole. Another sign of pathology is an ejection noise that manifests itself in systole;
electrical cardiography. This method helps to assess how overloaded the right ventricle is. The degree of congestion increases as the pressure rises in the right ventricular region. In this case, the electric axis has a deviation to the right.

Treatment of the disease

Isolated pulmonary stenosis in adults and children is treated in the following ways:

conservative. They are used for minor pathologies that cannot cause serious disruptions in work. of cardio-vascular system. Also used when the patient's parents refuse treatment with surgical intervention. They help relieve complications from myocardial ischemia (low oxygen supply to the heart muscle) and heart failure (incomplete heart failure to carry out its duties of transporting and pumping blood). Also, this method is used in preparation for surgery;
operational. Includes surgery. Stenosis of the mouth of the pulmonary artery is eliminated by expanding a narrow section in the vessel ( effective method treatment). The period in which the operation is to be performed is set for each patient separately. The operation can be performed while the baby is in the womb. In this case, the uterine walls are cut, and the fetus is operated on. The sooner the treatment is done, the better for the health of the child.

Prevention

There are no special preventive measures. To prevent the development of the disease, pregnant women are recommended:

to be registered in a consultation for women;
periodically visit an obstetrician-gynecologist;
get vaccinated against rubella 6 months before the desired pregnancy;
take any medication under medical supervision;
draw up a schedule of good nutrition and daily routine;
quit bad habits(smoking, drinking alcohol);
if a woman, as well as close relatives, have heart pathologies, careful monitoring of the condition of the fetus should be carried out for the timely detection of the disease and its early treatment;
not be exposed to chemical compounds, radiation, and other substances harmful to health;
to treat ailments before the desired pregnancy. This applies to expectant mothers who have autoimmune diseases (diseases in which a person's immunity destroys the tissues of his own body) and other severe pathologies (for example, diabetes).

Is everything correct in the article with medical point vision?

Answer only if you have proven medical knowledge

Diseases with similar symptoms:

Pulmonary hypertension is not an independent disease, but a specific syndrome of certain pathologies, which are interconnected by one distinguishing feature - it increases arterial pressure in the pulmonary artery. Also, during the progression of this pathological process, an increase in the load on the right ventricle is observed, which will later lead to its hypertrophy.

Pulmonary stenosis is a congenital heart defect. With this disease, the vein that supplies blood to the lungs is greatly narrowed, because of which the blood pressure in the right ventricle of the heart rises, resulting in its overstretching and impaired performance.

Symptoms of the disease

Pulmonary stenosis has a number characteristic symptoms, however, the signs will be different depending on the size of the lumen in the vessel.

Pulmonary stenosis in children is diagnosed by an electrocardiogram, and an x-ray and echocardiogram may be needed. Although usually this form of valve stenosis is discovered by chance during a routine examination by a cardiologist, for example, when an ultrasound of the heart is ordered. Here are a few characteristic symptoms that can be used to diagnose isolated stenosis:

the patient gets tired quickly and feels constant weakness in the limbs;
during physical exertion, a person experiences shortness of breath and pain in the heart area;
the skin becomes bluish;
dizziness and loss of consciousness are often noted.

On the left is a healthy heart with its pulmonary valve wide open to receive blood. In the picture on the right, we see an example of pulmonary stenosis, notice how little blood flows through the pulmonic valve.

Forms of stenosis

There are several types of pulmonary stenosis:

If there is a narrowing of the vessel next to the valve of the right ventricle, then such a stenosis of the mouth is called valvular. This part of the heart prevents blood flow from turning into reverse side. With this form of pathology in the valve, one of the three leaflets can be affected. The disease has a gradation: unicuspid, bicuspid or tricuspid stenosis.
If the narrowing affects the right ventricle under the pulmonary artery, then such a stenosis is called subvalvular.
When a vessel narrows below the ventricle, the stenosis is called supravalvular.

The valvular appearance, as well as the supravalvular one, often occurs with congenital heart disease (CHD).

Causes of stenosis

In medical practice, two groups of reasons are considered for which an isolated type of pathology may develop or occur:

congenital stenosis. The narrowing of the pulmonary artery occurs against the background of the fact that one of the parents had such a disease. That is, the pathology is hereditary in nature: the child receives it with a set of chromosomes of his parents.
Factors of environmental origin, that is, those that could cause mutations that led to stenosis of the pulmonary valve or the very mouth of the artery. Both types of pathology can develop under the influence of strong ionizing radiation. It damages DNA at the molecular level. Chemical mutagens that can cause pulmonic or valvular stenosis include alcohol, phenol, and nitrate found in tobacco, as well as some antibiotics. Rubella is a biological mutagen ( viral disease), diabetes. Sometimes it happens that isolated stenosis of the mouth is caused by lupus erythematosus, a systemic disease characterized by the fact that the immune system fights the tissues of its body.

Diagnosis of the disease

In order to get fast and proper treatment, it is necessary to consult a doctor at the first symptoms of stenosis. Even if the reason for the trip is insignificant, you do not need to wait until the disease develops and becomes difficult to control. The earlier congenital pulmonary stenosis is diagnosed, the better the prognosis of treatment.

Diagnostics consists of several stages:

Collection and analysis of anamnesis, during which the doctor finds out from the patient when the pains began, what their nature is, and the area of their localization. He will find out whether a similar phenomenon took place in the life of the patient in childhood, and if so, how did the symptoms pass. Next, he asks the patient about his performance, whether there is constant feeling fatigue, shortness of breath, whether the skin turns pale with increasing load. It also turns out whether there were similar cases of pathology in the patient's family. If so, to what extent is the person related to these people. Based on the history alone, an experienced physician can conclude whether the patient has developed stenosis of the mouth or valve.
According to the results of x-ray examination, it is determined whether the shape of the heart has changed, which is a clear sign of pulmonary stenosis.
Often, in order to diagnose stenosis of the mouth, etc., angiography is used. This is a method for detecting a narrowed mouth of a vessel by introducing a radioactive substance into the blood. This drug is displayed on the screen of a special device, showing vascular damage. The substance is then easily excreted from the blood without causing any harm to the body.
Echocardiography very clearly and easily reflects cardiac changes. With this method, it is possible to diagnose heart disease. A Doppler study allows you to reflect the work of the heart in a two-dimensional display.
Catheterization is the introduction of a catheter into the cavity of a vein or heart, which allows measuring blood pressure in these areas. This helps the doctor determine the next method of treatment: surgical or conservative.

It is not possible to collect an anamnesis from a newborn. You can only ask the parents for information about whether the child has relatives with a similar disease (isolated pulmonary stenosis, etc.). Only hardware diagnostic methods are used.

Treatment Methods

Treatment of arterial stenosis can be both conservative and operative: it depends on many factors that the doctor takes into account. Conservative therapy is used for different reasons: slight defect or refusal of parents to have surgery. Also, such treatment can give a positive result if the stenosis is moderate. So, non-surgical treatment is used in the following cases:

Against the background of oxygen deficiency, myocardial ischemia (heart muscle) develops.
Mild heart failure due to oxygen deprivation.
Preparation for the operation. If the patient's condition is not critical, then the operations are performed in order of priority. While waiting for their turn, a person undergoes conservative treatment.

The surgical method is used much more often than the conservative one, and it is much more effective. In this case, pulmonary stenosis is treated by physical expansion of the ostium of the vessel. Often the operation is performed on an emergency basis, when any delay can lead to the death of the patient.

There are also elective surgeries that treat pulmonary stenosis. The waiting time for the queue is determined by the doctor depending on the patient's condition. It is not uncommon for a vasodilation operation to be performed on a child who is still in the womb.

Complications of the disease

If pulmonary artery stenosis is not treated, especially its severe forms, then the development of associated diseases is possible:

Pathology often causes heart failure: the heart cannot fully pump blood, and the body weakens due to constant oxygen starvation.
Often the disease is complicated by bacterial endocarditis, that is, inflammation of the inside of the heart.
Stenosis is often accompanied by pneumonia.
A disrupted supply of blood and oxygen to the brain can cause a stroke.

Disease prevention

As such, there is no prevention of stenosis. There are a number of measures, following which, it is possible to diagnose the disease on early stages development and start treatment without severe consequences. For this you need:

After confirmation of pregnancy, register in the antenatal clinic.
At all stages of bearing a baby, consult a gynecologist and an obstetrician. The number of visits increases with the course of pregnancy, for example, at 8-9 months - every 10 days.
If there is a need to take drugs, then this should be done only with the permission and under the supervision of a doctor.
Get vaccinated against rubella 6 months before conception.
During pregnancy, try to monitor your diet and daily routine. Exclude exposure to the body of chemically hazardous elements or radiation.
You can not smoke tobacco and take alcohol.
If a woman has chronic illness, for example, diabetes, before conception, she must bring her body back to normal.
If there are cases of stenosis in the family, it is necessary to monitor the development of the child with special attention.

All these measures are designed to reduce the risk of moderate pulmonary stenosis in children to zero. And if he is genetically prone to this disease, then do not let him develop into severe form and immediately begin treatment after birth. By following these rules, a small stenosis will not develop into a deadly pathology and will be easily cured later. Be careful and take care of your health!

Pulmonary artery stenosis is one of the most common heart defects. Pathology lies in the fact that there is a narrowing of the lumen of the outflow tract of the right ventricle. Changes also apply to the pulmonary valve or part of the valves' vessels. One tenth of those with heart disease are diagnosed with pulmonary artery stenosis in newborns.

The disease differs in that there is an obstruction to blood flow in the pulmonary valve. The main reason for the formation of such an obstacle is the fused valve leaflets, which form a single membrane with a small hole. Valvular stenosis of the pulmonary artery most often develops in combination with other types of heart disease.

Causes of development and features of the disease

There are several reasons for the development of pulmonary artery stenosis in a newborn:

Heredity. At risk, first of all, are children whose relatives or parents have been diagnosed with heart disease;
Factors that negatively affect the course of pregnancy. These include the transfer of rubella by a pregnant woman, drug intoxication;
The presence of various severe hereditary diseases;
After the transfer of serious illnesses, in some cases, valve vegetation develops, and, consequently, stenosis;
The first birth of a woman over the age of 35;
Multiple pregnancy or chromosomal abnormalities in fetal development.

The development of the disease in each child is individual and has its own characteristics that affect the condition of the baby. If the size of the hole in the membrane is one millimeter, then the baby needs immediate surgical intervention, otherwise there is a direct threat to his life. In cases where the hole is of a normal shape, stenosis may not be detected immediately, but during the first years of a child's life. This is due to the fact that the symptomatology is rather inaccurate.

With the development of such a heart disease, the right ventricle performs its work, constantly overloading, due to which its walls are compacted, and the space of the internal cavity increases. It is for this reason that babies with stenosis require constant monitoring.

The correct indicator will “tell” how the disease develops - the pressure of the heart valve. If the difference between the ventricle on the right side and the pulmonary artery reaches the level of 50 millimeters of mercury, then this is an indicator for surgical intervention. Most often this happens at the age of 8-10 years.

As a rule, adults do not experience such a disease. Pulmonary stenosis is usually diagnosed during infancy.

Stages of the disease

Doctors distinguish 4 main stages of stenosis:

Stage 1 is a moderate stenosis of the pulmonary artery. The patient does not cause any worries and complaints, but on the results of the ECG, one can consider a slight overload in the work of the right ventricle of the heart;
Stage 2 - severe stenosis. This stage is characterized by the initial manifestation of the symptoms of the disease. Signs include systolic pressure;
Stage 3 - a sharp stenosis. This is a fairly severe stage of vice. With a sharp stenosis, problems in the work of the cardiovascular system, high blood pressure appear;
Stage 4 - decompensation. At this stage, pronounced signs of myocardial dystrophy, a serious circulatory disorder, and low systolic pressure appear.

Types of stenosis

Depending on the level of blood flow, there are three types of pulmonary artery stenosis in newborns. It should be noted right away that cases of a combined form of stenosis are possible. So, let's look at the main types:

a distinctive feature of valvular stenosis is that the walls of the valve grow together and at the same time form a dome shape with a hole in the center;
subvalvular stenosis is a funnel-shaped narrowing of the outflow tract of the right ventricle associated with an abnormal growth of fibrous tissue and muscle;
supravalvular stenosis is characterized by an incomplete or complete membrane, narrowing, and several peripheral stenoses.

Symptoms and diagnosis of stenosis

As in any disease, the symptoms directly depend on the stage of development of the stenosis. Narrowing can be both strong and moderate. At a pressure of about sixty millimeters of mercury, symptoms do not appear, treatment is most often not prescribed.

The most common symptoms are:

high fatigue in any physical activity, games;
frequent shortness of breath;
noises in the heart muscle, pain;
frequent dizziness and weakness;
possible fainting;
frequent heartbeat;
bluish tint of lips and fingertips;
pulsation of the veins in the neck.

It is possible to accurately diagnose heart muscle disease using an ECG procedure. The result of the examination will indicate signs of atrial and right ventricular delatation, and supraventricular arrhythmia can also be diagnosed.

However, an ECG will only help detect signs of the disease in stage 3 or 4 stenosis. Otherwise, the electrocardiogram will not reveal pathologies in the work of the heart, and it would be better to use echocardiography.

When diagnosing Special attention give the following data:

Noise is heard in the left side of the chest between the second and third ribs, and it is also clearly heard between the shoulder blades;
Displays symptoms of right ventricular hypertrophy;
X-ray images clearly show an increase in the trunk of the pulmonary artery.

Treatment of the disease

Stenosis can be treated with medication. As a rule, such techniques are used in the preoperative period or when trying to alleviate the patient's condition in the fourth stage of stenosis.

Treatment of pulmonary artery stenosis in newborns is prescribed in cases where too voluminous tissue seals are diagnosed and the hole becomes very small for normalized blood flow. In such situations, surgical intervention can be prescribed as early as the third day after the birth of the child.

The main goal of the operation is to remove excess tissue and restore normalized blood flow. If the pathology is not pronounced, then the operation is usually carried out at primary school age, and before that they simply pass regular examinations from cardiac surgeons.

In the preoperative period, all the recommendations of the doctor must be followed and special monitoring of the child is necessary, which includes:

periodic echocardiography;
prevention of infective endocarditis;
preventive antibiotic therapy procedures;
identification of sources of streptococcus.

After a thorough examination, surgical intervention is inevitable. This is the only effective method of dealing with pulmonary stenosis. Operations to eliminate heart defects have been successfully performed by cardiac surgeons since the mid-20th century. Moreover, over the past time, treatment methods have improved significantly.

Surgical intervention is most effective at the second or third stage of stenosis development.

Operation types

There are three types of operations in the diagnosis of pulmonary artery stenosis:

Closed pulmonary valvuloplasty. This type of surgery has previously been used to treat different kind heart defects, but gradually narrowed the range of application to the treatment of pulmonary stenosis. During the operation, the spliced walls of the valve are cut with specialized tools and the hole is expanded;
Pulmonary valvotomy. Surgical intervention is based on the use of a catheter;
Open valvotomy. During the operation, artificial circulation is connected and the rib cage to provide access to the heart muscle. Treatment of stenosis by a similar technique is considered the most effective.

After surgery, some complications may occur:

insufficient condition of the pulmonary valve, as a rule, such a complication is corrected by valve replacement;
violation through surgical intervention of the conduction system of the heart muscle;
damaged branch and, as a consequence, a heart attack.

An important stage of treatment is postoperative therapy, more precisely, observation. The duration of this stage is individual in each case and directly depends on the effectiveness of the operation. Regardless of the initial nature of bacterial endocarditis, its prevention continues. After surgery to correct the defect of the heart muscle, various physical exercises are allowed.

Prevention of the disease and prognosis of therapy

The most important and effective prevention heart disease is the provision of normal conditions for gestation. A pregnant woman should not be affected by dangerous external factors she should not come into contact with sick people infectious diseases have bad habits.

If, when examining a newborn, suspicions of pulmonary artery stenosis appear, the child should constantly undergo examinations by a cardiologist.

Modern medicine has a large and quite successful practice to combat this disease. Cardiac surgeons do not allow the development of pathology and usually perform surgery on time, thereby eliminating all the symptoms of stenosis. But if parents for some reason refuse treatment, the child lives on average to the age of five.

Do not despair, if the child is still in the womb, this diagnosis is made, the treatment of the disease is quite effective. Reviews of parents say that the child lives a full life after all the procedures.