Monika Kaldarárová1, Zuzana Berecová2, Iveta Šimková3
Regurgitation is a very frequent finding even in a morphologically normal pulmonary valve. Most often only a trivial regurgitation is present with no haemodynamic impact and no need for intervention. Haemodynamically relevant regurgitation is rare and most often it exists due to pulmonary hypertension or after some congenital heart defect correction. Severe regurgitation leads to right ventricular volume overload. Usually it is clinically silent for a long period; nevertheless, with time right heart failure and/or arrhythmias can occur. This status is progressive and can lead to patient’s death; so attention and if necessary also intervention is required. The diagnosis of pulmonary regurgitation and its secondary consequences (most significantly right ventricular dilatation and dysfunction) is possible by echocardiography and also by cardiac magnetic resonance. The use of all echocardiographic parameters known from other valves evaluation is possible, but unlikely to others, for the pulmonary valve limits for the degree of regurgitation and often even normal values do not exist. Magnetic resonance is a less available diagnostic tool, but nowadays it represents the gold standard for right ventricle evaluation. Based on its results, if necessary, further interventions in an asymptomatic patient are indicated. Nowadays in severe pulmonary regurgitation a surgical correction is possible and also percutaneous interventional techniques with an implantation of a valvular bioprosthesis or homograft. Important is the optimal timing of the procedure and severe pulmonary regurgitation elimination before right ventricular failure occurs. Therefore the management of severe pulmonary regurgitation belongs into the hands of a specialized center.