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European Heart Journal Advance Access published online on January 7, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi091
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European Heart Journal © The European Society of Cardiology 2005; all rights reserved

Review

Pulmonary regurgitation: not a benign lesion

Beatriz Bouzas 1, Philip J. Kilner 2, and Michael A. Gatzoulis 3*

1 Adult Congenital Heart Centre, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK; Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital and the National Heart and Lung Institute, Imperial College, London, UK
2 Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital and the National Heart and Lung Institute, Imperial College, London, UK
3 Adult Congenital Heart Centre, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK

* To whom correspondence should be addressed.
Michael A. Gatzoulis, E-mail: m.gatzoulis{at}rbh.nthames.nhs.uk


  Abstract

Pulmonary regurgitation (PR) is a common complication after surgical or percutaneous relief of pulmonary stenosis and following repair of tetralogy of Fallot. Significant PR is usually well tolerated in childhood. However, in the long term, chronic PR has a detrimental effect on right ventricular (RV) function and exercise capacity and leads to an increased risk of arrhythmia and sudden cardiac death (SCD). Recent advances in non-invasive imaging and, in particular, wider availability of cardiovascular magnetic resonance (CMR), have improved the assessment of PR and RV function in these patients. This in turn has facilitated decision making on the optimal timing for elective pulmonary valve replacement (PVR), which should be performed before irreversible RV dysfunction ensues.

Keywords: Pulmonary regurgitation; Cardiovascular magnetic resonance; Ventricular function.
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