Pulmonary Valve: Function, Anatomy, Conditions and Care
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What is the pulmonary valve?
The pulmonary valve is a three-leaflet heart valve between the right ventricle and the main pulmonary artery. It opens so oxygen-poor blood can travel to the lungs and closes to prevent backward leakage into the right ventricle. Problems are most often congenital. Pulmonary stenosis narrows the valve, while regurgitation lets blood leak back, and a cardiology professional should evaluate concerns.
What the research says
Valve narrowing can often be opened with a balloon procedure in adults. In 132 adults with congenital pulmonic stenosis, balloon valvuloplasty was successful (more than a 50% drop in the valve gradient) in 94%; the average pulmonary valve gradient fell from 70.7 to 29.0 mmHg over a mean follow-up of 5.7 years. Pulmonary regurgitation was reported in 17.4% of patients and 2 patients (1.5%) needed a repeat procedure for restenosis. This was a single-center retrospective study (Ananthakrishna et al., The Journal of Heart Valve Disease, 2014). [2]
Leakage and re-narrowing are the main long-term issues after valvuloplasty. A clinical review of pulmonic valve disease reports that pulmonic regurgitation and restenosis remain the main long-term sequelae of balloon valvuloplasty, that valve replacement is the procedure of choice for severe regurgitation with symptoms or hemodynamic effects, and that patients with pulmonic valve disease deserve lifelong surveillance (Fathallah & Krasuski, Current Cardiology Reports, 2017). [1]
The Ross procedure traded lower mortality for more reoperations. A meta-analysis of 6 observational studies (5,024 young adults) found lower mortality after the Ross procedure than after mechanical aortic valve replacement (HR 0.38, 95% CI 0.30–0.49; median follow-up 7.2 years) but a higher risk of reoperation (HR 1.91, 95% CI 1.36–2.70; median follow-up 9.3 years). The authors note the data are observational and call for randomized trials (Sá et al., Trends in Cardiovascular Medicine, 2024). [3]
What is the pulmonary valve?
The pulmonary valve is a heart valve that manages blood flow from the right ventricle, the lower-right chamber of the heart, to the pulmonary trunk. The pulmonary trunk is also called the main pulmonary artery.
From the pulmonary trunk, blood travels through the left and right pulmonary arteries to reach the lungs. The blood is oxygen-poor when it leaves the right ventricle. In the lungs, it gains oxygen and gets rid of carbon dioxide.
The pulmonary valve acts like a one-way door. It opens to let blood leave the right ventricle and closes to limit backward flow when the heart relaxes.
What does the pulmonary valve do?
The main function of the pulmonary valve is to coordinate blood flow from the right ventricle into the pulmonary trunk.
When the right ventricle contracts during systole, pressure opens the pulmonary valve. Blood moves out of the heart and toward the lungs.
When the heart relaxes during diastole, the pulmonary valve closes. This helps prevent blood from leaking backward into the right ventricle. While the valve is closed, the right ventricle fills with blood for the next contraction.
Heart phase | Pulmonary valve action | Blood-flow result |
Systole | Opens as the right ventricle contracts | Oxygen-poor blood moves into the pulmonary trunk |
Diastole | Closes as the heart relaxes | Backward flow into the right ventricle is limited |
Between beats | Remains coordinated with the heartbeat | The right ventricle fills for the next contraction |
The pulmonary valve is essential to the route that carries blood to the lungs. It does not add oxygen to the blood itself; the lungs perform that exchange after the blood arrives.
Why is it called the pulmonic valve?
Pulmonic valve is another name for pulmonary valve. The two terms refer to the same valve.
The pulmonary valve is one of the two semilunar valves of the heart. The aortic valve is the other. They are called semilunar valves because their leaflets have a shape that resembles crescent moons.
Semilunar valves are passageways between the heart’s lower chambers, called ventricles, and the arteries that carry blood away from the heart.
Term | Meaning |
Pulmonary valve | The valve that controls flow from the right ventricle toward the lungs |
Pulmonic valve | Another name for the pulmonary valve |
Semilunar valve | A valve between a ventricle and an artery |
Pulmonary trunk | The main pulmonary artery leaving the right ventricle |
Where is the pulmonary valve located?
The pulmonary valve is inside the heart. It connects the right ventricle with the pulmonary artery, or pulmonary trunk.
It is positioned in front of, slightly above and to the left of the aortic valve. Its location places it at the beginning of the route that carries oxygen-poor blood from the heart to the lungs.
Nearby structure | Relationship to the pulmonary valve |
Right ventricle | Lower heart chamber that sends blood through the valve |
Pulmonary trunk | Main artery that receives blood after it passes the valve |
Left and right pulmonary arteries | Carry blood from the pulmonary trunk toward the lungs |
Aortic valve | Another semilunar valve, positioned behind and to the right of the pulmonary valve |
Lungs | Where blood gains oxygen and gets rid of carbon dioxide |
What is the pulmonary valve made of?
The pulmonary valve has three leaflets, also called cusps or flaps. The three are the anterior cusp, left cusp and right cusp.
The cusps attach to a tough, fibrous ring of connective tissue called the annulus. Together, the leaflets and annulus form a structure that opens and closes with the heartbeat.
During diastole, the cusps close the opening. Complete closure helps prevent regurgitation, which means blood flowing backward into the right ventricle.
Pulmonary valve part | Function or description |
Anterior cusp | One of the valve’s three leaflets |
Left cusp | One of the valve’s three leaflets |
Right cusp | One of the valve’s three leaflets |
Annulus | Fibrous connective-tissue ring to which the cusps attach |
Valve opening | Passageway that allows blood to move from the right ventricle to the pulmonary trunk |
The valve’s structure is designed for repeated opening and closing. A problem with the leaflets, annulus or surrounding heart can change the way blood moves.
What is the pulmonary valve’s role in the Ross procedure?
The pulmonary valve can serve as a replacement for a diseased aortic valve in a surgery called the Ross procedure.
During this complex procedure, a surgeon removes the aortic valve and replaces it with the person’s pulmonary valve. The surgeon then places a donor pulmonary valve.
The pulmonary valve can serve as an aortic-valve replacement because it has similar anatomy and function. The Ross procedure is used for some children and adults under age 60 with aortic valve disease. It is a specialized surgical decision, not a general treatment recommendation.
Ross procedure step | General description |
Aortic valve | A diseased aortic valve is removed |
Native pulmonary valve | The person’s pulmonary valve is moved to the aortic position |
Donor valve | A donor pulmonary valve is placed in the pulmonary position |
Clinical decision | Suitability depends on the person’s heart condition and specialist assessment |
What conditions affect the pulmonary valve?
Pulmonary valve disease can take several forms. Most pulmonary valve problems are congenital heart conditions, meaning they are present at birth. Less often, a problem develops later in life, often in connection with another condition such as pulmonary hypertension.
The main conditions discussed here are pulmonary atresia, Tetralogy of Fallot, pulmonary valve stenosis, absent pulmonary valve and pulmonary or pulmonic valve regurgitation.
Condition | Basic meaning |
Pulmonary atresia | The valve does not develop properly or tissue blocks its opening |
Tetralogy of Fallot | A congenital heart condition involving four abnormalities, including possible pulmonary stenosis |
Pulmonary valve stenosis | The valve opening is narrowed |
Absent pulmonary valve | Valve leaflets are missing or underdeveloped, leading to stenosis and regurgitation |
Pulmonary valve regurgitation | The valve does not close fully and blood leaks backward |
A condition’s name describes an important feature, but it does not replace a complete cardiology evaluation.
What is pulmonary atresia?
Pulmonary atresia is a congenital heart condition in which a baby’s pulmonary valve does not develop properly or tissue blocks its opening.
When the opening is blocked or poorly formed, blood is redirected to other parts of the baby’s heart. The condition can cause cyanosis, which means low oxygen levels and a blue or gray appearance of the skin, lips or nail beds.
Pulmonary atresia is a serious condition that needs prompt evaluation and specialist care. Parents or caregivers should follow the treatment plan provided by the baby’s cardiology team.
What is Tetralogy of Fallot?
Tetralogy of Fallot is a congenital heart condition involving four abnormalities in a baby’s heart. One of those abnormalities is pulmonary stenosis, meaning a narrowed pulmonary valve and main pulmonary artery.
The narrowing can limit how much oxygen-rich blood circulates through the baby’s body. Tetralogy of Fallot is described as affecting about 1 in 2,500 babies born in the United States, and babies with the condition need surgery to correct the problem.
This frequency is a population estimate, not a personal risk calculation. A child with a suspected or known congenital heart condition should receive care from an appropriate pediatric cardiology team.
What is pulmonary valve stenosis?
Pulmonary valve stenosis means the valve is narrowed. It is usually congenital and often affects babies who have Tetralogy of Fallot.
A narrowed valve can make it harder for blood to move from the right ventricle into the pulmonary trunk. Treatment can include minimally invasive procedures to open the valve, and some people need a valve replacement.
Pulmonary stenosis rarely develops later in life in someone who was born with a normal, healthy pulmonary valve. The appropriate treatment depends on the severity, anatomy and overall heart health.
What is an absent pulmonary valve?
Absent pulmonary valve is a congenital heart condition in which the pulmonary valve’s leaflets are missing or underdeveloped.
It typically occurs in babies with Tetralogy of Fallot. The irregularity leads to pulmonary valve stenosis, meaning narrowing of the valve opening, plus regurgitation, meaning a leaky valve.
In this situation, blood can leak backward from the pulmonary trunk into the right ventricle. The condition often requires correction early in life.
Absent pulmonary valve is described as affecting about 1 in 50,000 babies. This is a population estimate and should not be used to calculate an individual baby’s risk.
What is pulmonary valve regurgitation?
Pulmonary or pulmonic valve regurgitation is a leaky-valve condition. The pulmonary valve does not close all the way with each heartbeat, allowing some blood to move backward from the pulmonary trunk into the right ventricle when the heart relaxes.
Pulmonary hypertension in older adults and congenital heart disease can contribute to regurgitation. It can also affect some people who previously had surgery to repair Tetralogy of Fallot.
Many people have a mild form of regurgitation. Moderate or severe cases may require treatment. Severe regurgitation over time can lead to dilation and failure of the right ventricle, swelling and fluid overload called edema.
Regurgitation feature | What it means |
Valve closure | The valve does not close completely |
Blood flow | Some blood moves backward into the right ventricle during diastole |
Severity | It may be mild, moderate or severe |
Possible long-term concern | Severe disease can contribute to right-ventricle dilation or failure and edema |
A diagnosis of regurgitation does not reveal severity by itself. Follow-up and treatment decisions belong with the cardiology team.
Can someone live without a pulmonary valve?
The pulmonary valve plays a vital role in sending blood to the lungs to receive oxygen. A properly working valve is necessary for life.
Serious pulmonary valve conditions in babies and children can shorten life when they are not treated. Treatment options and outlook depend on the specific condition, its severity and the child’s overall heart health.
A healthcare provider or pediatric cardiology team can explain treatment choices and life expectancy for an individual child. Avoid using general online descriptions to predict an individual outcome.
What symptoms can pulmonary valve disease cause?
The signs of pulmonary valve disease vary by condition, severity and age. Discussing pulmonary valve disease and treatment with a healthcare provider is especially important for babies and children with serious conditions.
Possible warning signs that merit prompt professional attention include blue or gray skin or lips, severe breathing difficulty, chest pain, fainting, rapidly worsening swelling or concerning symptoms in a baby or child with known or suspected heart disease. These signs require evaluation and do not identify one diagnosis.
Symptom or sign | Why it matters |
Blue or gray skin or lips | May reflect low oxygen levels, especially in a baby |
Severe breathing difficulty | Can signal a serious heart or lung problem |
Chest pain | Needs professional assessment, especially if severe or new |
Fainting | Can occur with serious cardiovascular problems and should be evaluated |
Rapidly worsening swelling | May be associated with fluid overload or another urgent condition |
New symptoms in a baby or child | Congenital heart conditions need timely pediatric evaluation |
A person can have mild or moderate valve disease without dramatic symptoms. Routine cardiology follow-up can be important even when someone feels well.
How are pulmonary valve problems evaluated?
Evaluation depends on the person’s age, medical history, known congenital heart conditions, symptoms and the suspected valve problem.
A cardiology professional may review the timing and severity of symptoms, prior heart surgery, known congenital heart disease, pulmonary hypertension and other conditions. Testing and follow-up are individualized.
Evaluation focus | Examples of information to discuss |
Blood-flow symptoms | Breathlessness, reduced exercise tolerance or concerning changes in a baby or child |
Oxygen-related signs | Blue or gray skin or lips |
Fluid-related signs | New or worsening swelling |
Heart history | Congenital heart disease, prior Tetralogy of Fallot repair or prior valve surgery |
Other medical conditions | Pulmonary hypertension or conditions that can affect the heart |
Treatment planning | Whether monitoring, a procedure, surgery or valve replacement is appropriate |
No single symptom can determine whether stenosis, regurgitation, atresia or another condition is present.
How can someone support heart health?
Pulmonary valve problems cannot always be prevented, especially when they are congenital. General heart-health habits can help keep the heart and valves working at their best.
The guidance includes avoiding smoking, vaping and tobacco products; drinking little or no alcohol; eating a heart-healthy diet; exercising regularly with a healthcare provider’s guidance; managing high blood pressure and high cholesterol; taking medication as prescribed; and attending yearly checkups.
People who are pregnant should seek appropriate prenatal and obstetric care. Such care can decrease the chances of congenital heart disease in newborns.
Heart-health habit | Practical focus |
Avoid tobacco | Do not smoke, vape or use tobacco products; seek help to quit |
Limit alcohol | Drink little or no alcohol |
Eat for heart health | Choose a balanced, heart-healthy dietary pattern |
Exercise with guidance | Follow an activity plan that fits the person’s health and valve condition |
Manage blood pressure and cholesterol | Work with a healthcare provider on monitoring and treatment |
Take prescribed medication | Follow the individual medication plan |
Attend checkups | Keep regular healthcare visits, including yearly checkups when advised |
Obtain prenatal care | Seek appropriate prenatal and obstetric care during pregnancy |
These habits support overall cardiovascular health. They cannot guarantee prevention of congenital or acquired pulmonary valve disease.
What questions should you ask a cardiology team about the pulmonary valve?
Questions about the pulmonary valve should cover what the finding means, how it affects blood flow to the lungs, its severity and which symptoms need urgent care.
What does the pulmonary valve finding mean in plain language?
Is the issue stenosis, regurgitation, atresia, absent leaflets or another condition?
How does the condition affect blood flow from the right ventricle to the lungs?
Is the problem congenital, acquired or related to another condition such as pulmonary hypertension?
What does the severity mean for monitoring and treatment?
What symptoms should prompt a same-day call or emergency care?
If my child has a congenital valve condition, which pediatric cardiology specialists should be involved?
If a procedure or valve replacement is discussed, what are its goals and limitations?
If the Ross procedure is being considered, why might it be appropriate or inappropriate?
Which types and amounts of exercise are appropriate for this heart condition?
What should I know about pregnancy and prenatal care?
When is the next follow-up visit or imaging study?
Conclusion
The pulmonary valve is the one-way gateway between the right ventricle and the pulmonary trunk. It opens during contraction so oxygen-poor blood can travel to the lungs, then closes during relaxation to limit backward flow.
The valve has three leaflets attached to a fibrous annulus and sits in front of and to the left of the aortic valve. Pulmonary valve problems are most often congenital, although later problems can be associated with conditions such as pulmonary hypertension.
Pulmonary atresia, Tetralogy of Fallot, pulmonary stenosis, absent pulmonary valve and pulmonary regurgitation are distinct conditions. Their effects and treatment needs can vary widely. General heart-health habits are useful, but they do not replace cardiology care.
Want a clearer next step for heart-valve questions? Read more about heart health and talk with a healthcare professional about any symptoms before making decisions.
Frequently Asked Questions
What is the pulmonary valve?
The pulmonary valve is a heart valve between the right ventricle and the pulmonary trunk. It controls the flow of oxygen-poor blood toward the lungs.
What is another name for the pulmonary valve?
Pulmonic valve is another name for pulmonary valve.
What does the pulmonary valve do?
The pulmonary valve opens when the right ventricle contracts, allowing blood to move into the pulmonary trunk. It closes when the heart relaxes to help prevent backward flow into the right ventricle.
Where is the pulmonary valve located?
The pulmonary valve is inside the heart, connecting the right ventricle to the pulmonary artery or pulmonary trunk. It is in front of and slightly to the left of the aortic valve.
How many leaflets does the pulmonary valve have?
The pulmonary valve has three leaflets, also called cusps or flaps: the anterior cusp, left cusp and right cusp.
What is the annulus?
The annulus is a tough, fibrous ring of connective tissue to which the pulmonary valve’s leaflets attach.
What is pulmonary valve stenosis?
Pulmonary valve stenosis is a narrowed pulmonary valve. It is usually congenital and can occur with Tetralogy of Fallot. Treatment may include a minimally invasive procedure or valve replacement for some people.
What is pulmonary valve regurgitation?
Pulmonary valve regurgitation is a leaky valve that does not close fully. Some blood moves backward from the pulmonary trunk into the right ventricle while the heart relaxes.
What is pulmonary atresia?
Pulmonary atresia is a congenital heart condition in which the pulmonary valve does not develop properly or tissue blocks its opening. It can redirect blood and cause low oxygen levels at birth.
What is Tetralogy of Fallot?
Tetralogy of Fallot is a congenital heart condition involving four abnormalities. One can be pulmonary stenosis, or narrowing of the pulmonary valve and main pulmonary artery.
What is an absent pulmonary valve?
An absent pulmonary valve is a congenital condition in which the valve’s leaflets are missing or underdeveloped. It can cause pulmonary stenosis plus regurgitation and often requires correction early in life.
Can pulmonary valve disease develop later in life?
Most pulmonary valve problems are congenital. Less often, they develop later, usually in connection with another medical condition such as pulmonary hypertension.
What is the Ross procedure?
The Ross procedure is a complex surgery in which a person’s pulmonary valve is moved to replace a diseased aortic valve, followed by placement of a donor pulmonary valve. It is used for some children and adults under age 60 with aortic valve disease.
Can someone live without a pulmonary valve?
A properly working pulmonary valve is necessary for life because it helps send blood to the lungs to receive oxygen. Serious untreated pulmonary valve conditions in babies and children can shorten life, so treatment and outlook should be discussed with the healthcare team.
How can someone support pulmonary valve health?
General heart-health guidance includes avoiding tobacco, drinking little or no alcohol, eating a heart-healthy diet, exercising with provider guidance, managing blood pressure and cholesterol, taking prescribed medication, attending checkups and obtaining appropriate prenatal care during pregnancy.
When should someone seek urgent care?
Seek prompt evaluation for blue or gray skin or lips, severe breathing trouble, chest pain, fainting, rapidly worsening swelling or concerning symptoms in a baby or child with known or suspected heart disease. These signs require assessment and do not identify one diagnosis.
Related Reading
Pulmonary Valve Stenosis: Complete Guide to Symptoms, Causes, Diagnosis, and Treatment explains how a narrowed pulmonary valve is found and treated.
Pulmonic Regurgitation: Navigating Blood Flow and Heart Valve Health explains what happens when the pulmonary valve leaks backward.
Transcatheter Pulmonary Valve Replacement (TPVR): Procedure, Recovery and Risks describes replacing the pulmonary valve through a catheter instead of open surgery.
Tetralogy of Fallot: A Parent's Guide to the Heart Condition Babies Are Born With — Symptoms, Diagnosis, and Surgery covers a congenital heart defect that often involves the pulmonary valve.
References
Fathallah M, Krasuski RA. Pulmonic valve disease: review of pathology and current treatment options. Curr Cardiol Rep. 2017;19(11):108. PMID 28916901. https://doi.org/10.1007/s11886-017-0922-2
Ananthakrishna A, Balasubramonium VR, Thazhath HK, et al. Balloon pulmonary valvuloplasty in adults: immediate and long-term outcomes. J Heart Valve Dis. 2014;23(4):511-515. PMID 25803978. https://pubmed.ncbi.nlm.nih.gov/25803978/
Sá MP, Van den Eynde J, Jacquemyn X, et al. Long-term outcomes of Ross procedure versus mechanical aortic valve replacement: meta-analysis of reconstructed time-to-event data. Trends Cardiovasc Med. 2024;34(1):29-36. PMID 35750311. https://doi.org/10.1016/j.tcm.2022.06.005
Centers for Disease Control and Prevention. About Congenital Heart Defects. CDC. Updated October 14, 2026. https://www.cdc.gov/heart-defects/about/index.html
National Heart, Lung, and Blood Institute. What Are Heart Valve Diseases? NHLBI. Last updated March 24, 2022. https://www.nhlbi.nih.gov/health/heart-valve-diseases
Disclaimer
This article is for general educational purposes and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition.
It explains pulmonary valve anatomy, blood flow, semilunar-valve structure, the Ross procedure, congenital valve conditions, stenosis, regurgitation and general heart-health habits. It does not diagnose pulmonary valve disease, pulmonary hypertension, congenital heart disease or heart failure, and it does not recommend a specific procedure or surgery. The approximate 1-in-2,500 and 1-in-50,000 figures are population estimates, not personal risk calculations.
Comments