Monitoring
Pulmonary regurgitation may worsen over time. Periodic echocardiogram with Doppler color flow studies will provide serial assessment of progression of pulmonary regurgitation and right ventricular size and function. In cases of significant pulmonary regurgitation, exercise capacity should be assessed and documented, observing for a change or decrease in function. The aim is to assess and accurately decide on the need and timing for pulmonary valve replacement.
After pulmonary valve replacement, patients should be followed up at 30 days and then 6 months, followed by yearly visits. In general, all patients who receive a mechanical valve require lifelong anticoagulation. International normalized ratio should be monitored and kept between 2.5 and 3.5. Frequency of monitoring should be individualized according to the patient's need and response.
Transition from pediatric to adult care warrants development of a healthcare transition program.[30]
Use of this content is subject to our disclaimer