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Pediatric Pulmonary Stenosis

Anatomy of the heart, view of the valves

Pulmonary stenosis is a congenital (present at birth) defect that occurs due to abnormal development of the prenatal heart during the first eight weeks of pregnancy.

The pulmonary valve is found between the right ventricle and the pulmonary artery. It has three leaflets that function like a one-way door, allowing blood to flow forward into the pulmonary artery, but not backward into the right ventricle.

With pulmonary stenosis, problems with the pulmonary valve make it harder for the leaflets to open and permit blood to flow forward from the right ventricle to the lungs in a normal fashion. In children, these problems can include:

  • A valve that has leaflets that are partially fused together.

  • A valve that has thick leaflets that do not open all the way.

  • The area above or below the pulmonary valve is narrowed.

There are four different types of pulmonary stenosis:

  • Valvar pulmonary stenosis. The valve leaflets are thickened and/or narrowed 

  • Supravalvar pulmonary stenosis. The pulmonary artery just above the pulmonary valve is narrowed

  • Subvalvar (infundibular) pulmonary stenosis. The muscle under the valve area is thickened, narrowing the outflow tract from the right ventricle

  • Branch peripheral pulmonic stenosis. The right or left pulmonary artery is narrowed, or both may be narrowed

Illustration of pulmonary stenosis

Pulmonary stenosis may be present in varying degrees, classified according to how much obstruction to blood flow is present. A child with severe pulmonary stenosis could be quite ill, with major symptoms noted early in life. A child with mild pulmonary stenosis may have few or no symptoms, or perhaps none until later in adulthood. A moderate or severe degree of obstruction can become worse with time.

Pulmonary stenosis is a component of half of all complex congenital heart defects.

Pulmonary stenosis accounts for 5 to 10 percent of all congenital heart defect cases.

Children's Team

Children's Team

Providers

Joshua Kanter

Joshua Kanter

Medical Director, Interventional Cardiology
Interventional Cardiologist
Tacy Downing, MD

Tacy Downing

Interventional Cardiologist
Adult Congenital Cardiologist
Departments

Departments

Cardiac Imaging

We have expertise in the full spectrum of cardiac imaging, including transesophageal, prenatal, 3-D, intracardiac, and stress echocardiography and cardiac MRI.

Cardiac Catheterization

We perform hundreds of catheterization procedures every year. We treat children with the most complex heart, blood vessel, and valve conditions. We have one of the highest success rates for cardiac catheterization procedures. Learn more about Cardiac Catheterization.

Prenatal Cardiology Program

Children diagnosed with heart conditions before they are born receive comprehensive, expert care from our fetal cardiology specialists. Learn more about our Prenatal Cardiology Program.

Cardiac Surgery

Our pediatric heart surgery team performs twice the number of surgeries of any other hospital in the region, with some of the best outcomes in the nation.

Children's National Heart Institute

Our expert pediatric heart team, including more than 40 subspecialties, offer advanced heart care and excellent outcomes for thousands of children every year.

Cardiology

The pediatric heart experts at Children’s National Hospital in Washington, D.C., provide advanced care for unborn babies, children and young adults with heart conditions.