Saturday, November 13, 2010

Pulmonary artery stenosis

Pulmonary Artery Stenosis
Pulmonary valve is conical or dome shaped formed by the fusion of valve leaflets and may be bicuspid.

1 - narrowed pulmonary valve
Blood flow patterns are normal but blood flow through the
pulmonary artery is reduced as indicated by the broken white arrows.

Obstructive defect... Generally, severe stenoses in the neonatal period are associated with CHF symptoms and/or cyanosis depending on the location of the lesion.

Considered a right outflow tract obstruction.

In severe cases there may be tricuspid regurgitation and RA dilatation.

In the neonatal period, patients may present with symptoms of right-sided heart failure or cyanosis.

The presence of cyanosis from right to left shunting indicates moderate pulmonary stenosis

Oxygen saturations usually normal

Severe pulmonary stenosis can be associated with decreased cardiac output, right ventricular hypertrophy, early congestive heart failure (CHF), and cyanosis.

IV, O2, Monitor

3cc/kg/hr D10W  for infants under 1 year of age, D5W if over 1 year.

If the patient has a known large left-to-right shunt, such as PDA or ventriculoseptal defect (VSD) and is in respiratory distress consider Lasix.

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