Variations of the pulmonary valve

Abstract

Objectives: The human pulmonary valve is an important structure and knowledge about its normal anatomy is essential in detecting valve diseases and in valve replacement surgeries. The normal pulmonary valve has three semilunar cusps or leaflets. The valve is known to present anatomical variations with respect to number of cusps, circumference and presence of fenestrations. The aim of the study is to detect and record such variations. A prospective observational type of study on 213 randomly selected autopsy cases with age ranging from 2 to 89 years was conducted at Government Medical College, Kozhikode, Kerala with consent from Institutional Ethics Committee. Methods: Pulmonary valves from hearts dissected during autopsy were washed thoroughly and fixed in formalin. Each specimen was numbered systematically. Circumference was measured. Age, sex, height, weight, weight of the heart and other cardiac anomalies, if any, were recorded. Results: 1) Out of 213 cases, 211 valves had 3 cusps (99.06%), one valve had two cusps (0.46%) and one had four cusps (0.46%). 2) Fenestrations were seen in 103 valves (48.35%). 3) Cusps were asymmetrical in 15 valves (7.04%). 4) Circumference of the valve had a significant relation to age and sex of the individual. Conclusions: The anatomical variations occurring in the pulmonary valve have significant clinical relevance in the diagnosis, management and prevention of valve diseases, valve repair and valve replacement surgeries.