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Pulmonary Regurgitation
Franklin Dana, MD; John D. Grizzard, MD; Kathryn M. Olsen, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Pulmonary regurgitation (PR)
            • Synonyms

              • Pulmonary insufficiency (PI)
            • Definitions

              • Reversed flow from pulmonary artery (PA) through incompetent or absent pulmonic valve into right ventricle (RV) in diastole

            IMAGING

            • General Features

              • Radiographic Findings

                • MR Findings

                  • Echocardiographic Findings

                    • CT Findings

                      • Angiographic Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Reporting Tips

                                              Selected References

                                              1. Beurskens N: Diagnostic value of Doppler echocardiography for identifying hemodynamic significant pulmonary valve regurgitation in tetralogy of Fallot: comparison with MRI. Int J Cardiovasc Imaging. 33:1723-30, 2017
                                              2. Pignatelli RH et al: Imaging of the pulmonary valve in the adults. Curr Opin Cardiol. 32(5):529-40, 2017
                                              3. Alvarez-Fuente et al: Timing of pulmonary valve replacement: how much can the right ventricle dilate before it loses its remodeling potential? Pediatric Cardiology. 37(3): 601-5, 2016
                                              4. Rajiah P et al: CT and MRI of pulmonary valvular abnormalities. Clin Radiol. 69(6):630-8, 2014
                                              5. Luijnenburg SE et al: Exercise capacity and ventricular function in patients treated for isolated pulmonary valve stenosis or tetralogy of Fallot. Int J Cardiol. 158(3):359-63, 2012
                                              6. Mercer-Rosa L et al: Quantifying pulmonary regurgitation and right ventricular function in surgically repaired tetralogy of Fallot: a comparative analysis of echocardiography and magnetic resonance imaging. Circ Cardiovasc Imaging. 5(5):637-43, 2012
                                              7. Quail MA et al: Impact of pulmonary valve replacement in tetralogy of Fallot with pulmonary regurgitation: a comparison of intervention and nonintervention. Ann Thorac Surg. 94(5):1619-26, 2012
                                              8. Geva T: Repaired tetralogy of Fallot: the roles of cardiovascular magnetic resonance in evaluating pathophysiology and for pulmonary valve replacement decision support. J Cardiovasc Magn Reson. 13:9, 2011
                                              9. Oosterhof T et al: Opportunities in pulmonary valve replacement. Expert Rev Cardiovasc Ther. 7(9):1117-22, 2009
                                              10. Kilner PJ: Imaging congenital heart disease in adults. Br J Radiol. 84 Spec No 3:S258-68, 2011
                                              11. Bouzas B et al: Pulmonary regurgitation: not a benign lesion. Eur Heart J. 26(5):433-9, 2005
                                              12. Rao PS: Pulmonary valve disease. In Alpert JS et al: Valvular Heart Disease. 3rd ed. Philadelphia: Lippincott William and Wilkins, 2000
                                              13. Otto CM: Right-sided valve disease. In Otto CM: Valvular Heart Disease. 1st ed. Philadelphia: W. B. Saunders Co., 1999
                                              14. Gorcsan J et al: Echocardiographic Assessment of Myocardial Strain. JACC. Vol.58, No.14, 1401-13, 2011.
                                              15. Yamasaki Y et al: Quantitative assessment of right ventricular function and pulmonary regurgitation in surgically repaired tetralogy of Fallot using 256-slice CT: comparison with 3-Tesla MRI. Eur Radiol 24(12):3289-99, 2014
                                              16. Devos D et al: Calculations of cardiovascular shunts and regurgitation using MR ventricular volume and aortic and pulmonary flow measurements. Eur Radiol 20:410-421, 2010
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Pulmonary regurgitation (PR)
                                                        • Synonyms

                                                          • Pulmonary insufficiency (PI)
                                                        • Definitions

                                                          • Reversed flow from pulmonary artery (PA) through incompetent or absent pulmonic valve into right ventricle (RV) in diastole

                                                        IMAGING

                                                        • General Features

                                                          • Radiographic Findings

                                                            • MR Findings

                                                              • Echocardiographic Findings

                                                                • CT Findings

                                                                  • Angiographic Findings

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Staging, Grading, & Classification

                                                                            • Gross Pathologic & Surgical Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Reporting Tips

                                                                                          Selected References

                                                                                          1. Beurskens N: Diagnostic value of Doppler echocardiography for identifying hemodynamic significant pulmonary valve regurgitation in tetralogy of Fallot: comparison with MRI. Int J Cardiovasc Imaging. 33:1723-30, 2017
                                                                                          2. Pignatelli RH et al: Imaging of the pulmonary valve in the adults. Curr Opin Cardiol. 32(5):529-40, 2017
                                                                                          3. Alvarez-Fuente et al: Timing of pulmonary valve replacement: how much can the right ventricle dilate before it loses its remodeling potential? Pediatric Cardiology. 37(3): 601-5, 2016
                                                                                          4. Rajiah P et al: CT and MRI of pulmonary valvular abnormalities. Clin Radiol. 69(6):630-8, 2014
                                                                                          5. Luijnenburg SE et al: Exercise capacity and ventricular function in patients treated for isolated pulmonary valve stenosis or tetralogy of Fallot. Int J Cardiol. 158(3):359-63, 2012
                                                                                          6. Mercer-Rosa L et al: Quantifying pulmonary regurgitation and right ventricular function in surgically repaired tetralogy of Fallot: a comparative analysis of echocardiography and magnetic resonance imaging. Circ Cardiovasc Imaging. 5(5):637-43, 2012
                                                                                          7. Quail MA et al: Impact of pulmonary valve replacement in tetralogy of Fallot with pulmonary regurgitation: a comparison of intervention and nonintervention. Ann Thorac Surg. 94(5):1619-26, 2012
                                                                                          8. Geva T: Repaired tetralogy of Fallot: the roles of cardiovascular magnetic resonance in evaluating pathophysiology and for pulmonary valve replacement decision support. J Cardiovasc Magn Reson. 13:9, 2011
                                                                                          9. Oosterhof T et al: Opportunities in pulmonary valve replacement. Expert Rev Cardiovasc Ther. 7(9):1117-22, 2009
                                                                                          10. Kilner PJ: Imaging congenital heart disease in adults. Br J Radiol. 84 Spec No 3:S258-68, 2011
                                                                                          11. Bouzas B et al: Pulmonary regurgitation: not a benign lesion. Eur Heart J. 26(5):433-9, 2005
                                                                                          12. Rao PS: Pulmonary valve disease. In Alpert JS et al: Valvular Heart Disease. 3rd ed. Philadelphia: Lippincott William and Wilkins, 2000
                                                                                          13. Otto CM: Right-sided valve disease. In Otto CM: Valvular Heart Disease. 1st ed. Philadelphia: W. B. Saunders Co., 1999
                                                                                          14. Gorcsan J et al: Echocardiographic Assessment of Myocardial Strain. JACC. Vol.58, No.14, 1401-13, 2011.
                                                                                          15. Yamasaki Y et al: Quantitative assessment of right ventricular function and pulmonary regurgitation in surgically repaired tetralogy of Fallot using 256-slice CT: comparison with 3-Tesla MRI. Eur Radiol 24(12):3289-99, 2014
                                                                                          16. Devos D et al: Calculations of cardiovascular shunts and regurgitation using MR ventricular volume and aortic and pulmonary flow measurements. Eur Radiol 20:410-421, 2010