Case series and literature review on functional pulmonary atresia in neonates functional PA in neonates: case & review.
Yalun Qu, Shuang Yang, Yongtao Wu et al.
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Case in brief
This report describes five neonates diagnosed with functional pulmonary atresia, in which a structurally normal pulmonary valve fails to open. Echocardiographic findings used to support the diagnosis included diastolic retrograde flow through the valve, significant tricuspid regurgitation, marked right-heart enlargement, and subsequent restoration of forward flow. All five infants recovered antegrade pulmonary-valve flow after individualized medical management; one also required surgery as the ductus arteriosus and foramen ovale progressively closed. All were discharged successfully.
What made this case unusual
The apparent pulmonary-valve obstruction occurred despite a structurally normal valve and resolved with restoration of forward flow, distinguishing functional atresia from fixed anatomic obstruction.
Diagnostic / clinical pearl
In a neonate with absent pulmonary-valve opening, assess valve structure and Doppler flow, right-heart findings, and change on follow-up echocardiography to recognize functional rather than fixed obstruction.
Why it matters
Recognizing functional pulmonary atresia may help avoid unnecessary surgery; management in this series was individualized, with surgery needed in one infant.