Pulmonary Valve Insufficiency

Contact Information

(608) 263-6311

(608) 263-6420


Related Resources

Adult Congenital Heart Disease Program

Pediatric Congenital Heart Disease Program

The pulmonary valve directs blood from the right ventricle into the pulmonary artery (the large vessel that carries oxygen-poor blood to the lungs). If the pulmonary valve is leaky (insufficient), some blood may flow back into the ventricle, instead of out to the lungs.
Pulmonary valve insufficiency is most often found in patients who had surgical repair for Tetralogy of Fallot as children.
Concerns and Symptoms
Because the insufficient pulmonary valve allows blood to backflow, the right ventricle's workload increases. The right ventricle, and possibly the right atrium, may begin to dilate. This can result in an abnormal heartbeat (arrhythmia). Patients with arrhythmia will undergo an Electrophysiology (EP) Study to determine its type and severity.
Other symptoms may include:
  • Fatigue
  • Shortness of breath
  • Heavy or rapid breathing, especially during exercise



In cases of severe pulmonary insufficiency, surgical replacement of the valve is necessary. The operation is performed under general anesthesia, which means you will be asleep during surgery.


First, the surgeon makes a vertical incision in the front of the chest, opens the breastbone, and exposes the heart. Blood from the heart is redirected to a bypass machine. The bypass machine does the job of the heart and lungs during the operation.


The surgeon then replaces the pulmonary valve with a biological valve or a homograft (from a human donor). He also may use a tissue graft from an animal donor to reconstruct the right ventricle's outflow tract.


Patients with arrhythmia may also undergo a MAZE procedure or ventricular cryoablation at the same time as the valve replacement. These procedures correct the electrical imbalance that causes the arrhythmia.


After the valve is replaced, and the heart closed, the surgeon shuts down the heart-lung bypass machine, and the heart starts beating again. The surgeon then closes the breastbone and chest incision, and applies bandages to the incision site.