Case series and literature review on functional pulmonary atresia in neonates functional PA in neonates: case & review

BACKGROUND: Functional pulmonary atresia (FPA) is a rare neonatal condition charac-terized by the failure of a structurally normal pulmonary valve to open. METHODS: This case series analyzed five neonates diagnosed with FPA and reviewed relevant literature. The diagnostic criteria for FPA included: (1) retrograde flow through the pulmonary valve during diastole; (2) significant tricuspid regurgitation with estimation of right ventricular pressure by tricuspid regurgitation peak velocity; (3) marked right heart enlargement; and (4) resolution of pulmonary valve obstruction with restoration of antegrade flow on follow-up echocardiography. RESULTS: All five patients demonstrated recovery of forward flow across the pulmonary valve following individualized medical management. One neonate required surgical intervention due to progressive closure of the ductus arteriosus and foramen ovale. Ultimately, all five neonates were successfully discharged. CONCLUSION: Prompt and accurate recognition of FPA is critical to prevent unnecessary surgical procedures, and tailored therapeutic strategies can promote reopening of the pulmonary valve, resulting in favorable clinical outcomes.