Pulmonary atresia is a form of heart disease that occurs from birth (congenital heart disease), in which the pulmonary valve does not form properly. The pulmonary valve is an opening on the right side of the heart that regulates blood flow from the right ventricle (right side pumping chamber) to the lungs.
In pulmonary atresia, a solid sheet of tissue forms where the valve opening should be, and the valve stays closed. Because of this defect, blood from the right side of the heart cannot go to the lungs to pick up oxygen.
If the person does not have a VSD, the condition is called pulmonary atresia with intact ventricular septum (PA/IVS).
If the person has both problems, the condition is called pulmonary atresia with VSD. This is an extreme form of tetralogy of Fallot.
Although both conditions are called pulmonary atresia, they are actually different defects. This article discusses pulmonary atresia without a VSD.
Persons with pulmonary atresia with intact ventricular septum may also have a poorly developed tricuspid valve. They may also have an underdeveloped right ventricle and abnormal blood vessels feeding the heart.
Symptoms usually occur in the first few hours of life, although it may take up to a few days.
Symptoms may include:
Bluish colored skin (cyanosis)
Poor eating habits (babies may get tired while nursing or sweat during feedings)
Shortness of breath
Exams and Tests
The health care provider will use a stethoscope to listen to the heart and lungs. Persons with a PDA have a heart murmur that can be heard with a stethoscope.
The following tests may be ordered:
Pulse oximetry - shows the amount of oxygen in the blood
A medicine called prostaglandin E1 is usually used to help the blood move (circulate) into the lungs. This medicine keeps a blood vessel open between the pulmonary artery and aorta. The vessel is called a patent ductus arteriosus (PDA).
Multiple treatments are possible, but depend on the extent of the heart abnormalities that accompany the pulmonary valve defect. Potential treatments include:
A thin, flexible tube (heart catheterization) to repair the problem
Open heart surgery to repair or replace the valve, or to place a tube between the right ventricle and the pulmonary (lung) arteries
Reconstructing the heart as a single ventricle (one pumping chamber instead of two)
Most cases can be helped with surgery. How well a baby does depends on:
Size and connections of the pulmonary artery (the artery that takes blood to the lungs)
How well the heart is beating
How well the other heart valves are formed or how much they are leaking
Outcome varies because of the different forms of this defect. A baby may need only a single procedure or could need three or more surgeries and have only a single working ventricle.
Delayed growth and development
When to Contact a Medical Professional
Call your health care provider if the baby has:
Skin or nails that appear blue (cyanosis)
There is no known way to prevent this condition.
All pregnant women should receive routine prenatal care. Many congenital defects can be discovered on routine ultrasound examinations.
If the defect is found before birth, medical specialists (such as a pediatric cardiologist, cardiothoracic surgeon, and neonatologist) can be present at the birth, and ready to help as needed. This preparation can mean the difference between life and death for some babies.
Webb GD, Smallhorn JF, Therrien J, Redington AN. Congenital heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 65.
Kurt R. Schumacher, MD, Pediatric Cardiology, University of Michigan Congenital Heart Center, Ann Arbor, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.