Coronary angiography if there is suspicion of coronary artery disease, or in patients over the age of 40 years in whom surgery is being planned. There are significant arrhythmias. An episode of endocarditis has occurred. Severe pulmonic regurgitation associated with reduced exercise capacity of cardiovascular cause or evidence of deteriorating right ventricular function especially with the onset of tricuspid regurgitation. The long term results of surgical pulmonary valvotomy are established.
Clinical outcomes are excellent.
Occasionally pulmonary regurgitation may progress and become severe enough to warrant re-intervention. Patients treated with balloon valvuloplasty, in the absence of a dysplastic valve, probably have the same prognosis as those who have had surgical valvotomy at least in the medium term. In most instances, this should be at an RRC for ACHD patients.