Pulmonary Valve Stenosis

Pulmonary valve stenosis is usually a well-tolerated cardiac lesion normally exhibiting a gradual progression. Sudden incapacitation may, however, occur in certain circumstances.

Waiting period

Minimum — 1 month if post-balloon valvuloplasty

Minimum — 3 months if post-surgical valvotomy

NOTE: If more than one waiting period applies (because of multiple cardiac conditions or other comorbid diseases), examine the driver for certification after the completion of the longest waiting period.

Decision

Maximum certification period — 1 year

Recommend to certify if:

The driver has:

• Mild or moderate pulmonary valve stenosis.
• Pulmonary valve stenosis corrected by surgical valvotomy or balloon valvuloplasty.

Recommend not to certify if:

The driver has:

• Symptoms of dyspnea, palpitations, or syncope.
• Pulmonary valve peak gradient greater than 50 mm Hg in the presence of a normal cardiac output.
• Right ventricular pressure greater than 50% systemic pressure.
• More than mild right ventricular hypertrophy noted by echocardiography.
• More than mild right ventricular dysfunction noted by echocardiography.
• More than moderate pulmonary valve regurgitation noted by echocardiography.
• Main pulmonary artery diameter more than 5 cm noted by echocardiography or other imaging modality.

Monitoring/Testing

The driver should have annual cardiology evaluations by a cardiovascular specialist who is knowledgeable in adult congenital heart disease and who understands the functions and demands of commercial driving.

Follow-up

The driver should have an annual medical examination.

Congenital Heart Disease Recommendation Table (PDF)

The complete text of the medical conference reports can be accessed from FMCSA Medical Reports.