Pulmonary Valve Stenosis and Altitude?

My 3 1/2 month old baby was diagnosed with critical pulmonary valve stenosis at birth and had a balloon valvuloplasty at 24 hours old.  The procedure went perfectly and her doctors were very pleased with the results, saying that they did not anticipate ever having to repeat the procedure.  We were told that we should not fly with her when she was first born.  They have told us and her pediatrician that she is so good that she should be treated as any other child.  
I am hoping for a second opinion on when it would be completely safe to fly with her or take her to the mountains?  Thanks.  

[Darcy Green Conaway, MD]

There are really two issues here:
1)What is the long-term prognosis/complication rate? and
2)When can your child fly?

To answer the first, I'm not sure that I totally agree that it is likely that your child will ever need more procedures on that valve; as an adult cardiologist I have seen patients that go on to have a very leaky pulmonic valve post-repair-- while it is true that it often does not require surgery to fix and may not even happen,I think it is a real possibility.Your baby will very likely follow with a pediatric cardiologist until about 18 years of age and then will move on to see an adult cardiologist.
In the neonate, pulmonic stenosis the circulation is often dependent on a patent ductus arteriosus ( a way to "bypass the lungs" so to speak)- your child probably may have had this occluded after the pulmonic stenosis was repaired if it was significant in size. If not,which is what I suspect, then the no flying issue is very likely due to the fact that at high altitudes there is less oxygen-- if a patent ductus is still there and the oxygen drops it can create higher pressures in the pulmonary artery and decrease blood flow..regarding when to fly and the safety of that--this should be discussed with a pediatric cardiologist as I do not know if there were other defects to be discussed, such as an atrial septal defect, patent foramen ovale, etc. Make sure you discuss this very thoroughly with the pediatric cardiologist before any travel! I hope this was helpful.

[Becky498]

A related discussion, Leaking Pulmonary Valve was started.

[amalia595]

A related discussion, pulmonary stenosis and congenital rubella was started.