Pulmonary valve motion in valvular pulmonary stenosis in childhood

Echocardiography tracings of the pulmonary valve was recorded in 16 patients with pulmonic stenosis (PS) ranging in ages from 6 to 14 years (average 10 years). 11 patients had an isolated PS and 5 had a PS associated with atrial septal defect. In 2 patients with mild PS (gradient 15 mm Hg) the depth of the "a" wave was normal: 3 and 4 mm. In 14 patients with moderate or severe PS (gradient 40 mm to 200 mm Hg), the maximal depth of the "a" wave was less than 6 mm in 2 patients, and more than 6 mm in 12 patients (range 7 to 15 mm, average 10 mm). The motion of both anterior and posterior pulmonary valve leaflets was well recorded in 3 patients with severe PS. The "a" wave showed a posterior motion of the posterior leaflets and an anterior motion of the anterior leaflet. This motion is due to the premature pulmonary valve opening.