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Melody valve

Rodrigo Rios, Susan R Foerster, Todd M Gudausky
The Melody® transcatheter pulmonary valve system was developed for placement within right ventricle-to-pulmonary artery conduits in patients with CHD for treatment of stenosis or regurgitation, providing an alternative to open-heart surgery. Abnormal systemic venous connections altering the catheter course to the right ventricle-to-pulmonary artery conduit may present a challenge to Melody® valve implantation. We present two such cases, in which the Melody® valve was successfully implanted in teenage patients with congenitally corrected transposition of the great arteries after Senning atrial switch operation...
October 17, 2016: Cardiology in the Young
Patrick O Myers
No abstract text is available yet for this article.
September 16, 2016: Journal of Thoracic and Cardiovascular Surgery
Inês C Mendes, Fernando Maymone-Martins, Rui Anjos
A 30-year-old female with tricuspid valve atresia, ventricular septal defect, and atrial septal defect had a neonatal modified Blalock Taussig shunt and a Fontan-Björk operation performed at five years of age. She did well initially but progressively developed signs of systemic congestion due to severe homograft stenosis and underwent successful percutaneous implantation of a Melody(®) pulmonary valve (Medtronic, Minneapolis, MN, USA) in the "tricuspid" position.
October 4, 2016: Journal of Cardiac Surgery
Sormeh Salehian, Abhinav Rastogi, Olivier Ghez, Margarita Burmester
Group B streptococcus (GBS) is recognised as one of the leading organisms in early-onset neonatal sepsis but is also a cause of late-onset GBS septicaemia, meningitis and rarely, infective endocarditis (IE). We report a case of a healthy term neonate who developed GBS septicaemia and meningitis having presented with parental concern and poor feeding. Subsequent identification and treatment of GBS resulted in the requirement for long-line intravascular access in order to administer antibiotic therapy. One week later, after repeated parental concern and symptoms of shortness of breath, the neonate presented to Accident and Emergency and subsequently a Paediatric Cardiorespiratory Intensive Care Unit where emergency resuscitation procedures were required and diagnosis of severe IE affecting the mitral valve was made...
2016: BMJ Case Reports
Paul J Chai
No abstract text is available yet for this article.
August 28, 2016: Journal of Thoracic and Cardiovascular Surgery
Rouven Kubicki, Brigitte Stiller, Jochen Grohmann
Pseudoaneurysm formation is a rare but potentially life-threatening complication after surgical repair of congenital heart disease. We present a boy with truncus arteriosus communis 14 years after homograft placement in pulmonary position. On follow-up, he presented progressive chronic homograft degeneration. Moreover, a large pseudoaneurysm in the right ventricular outflow tract was surprisingly depicted. We opted for a two-stage interventional approach.
2016: SpringerPlus
Donald J Hagler
Current delivery systems for the Sapien XT valve for the native pulmonary valve are unacceptable stiff and poorly design for implantation in the pulmonary outflow tract. This report details improvisation of the Melody Ensemble for easier pulmonary outflow tract delivery of the Sapien XT valve. The unacceptable cost of the utilization of two delivery systems for valve implantation, requires industry development of an safe, effective delivery system appropriate for the pulmonary outflow tract.
September 2016: Catheterization and Cardiovascular Interventions
Giselle Y Barraza, Claudia Fernandez, Claudia Halaby, Sara Ambrosio, Edwin F Simpser, Melodi B Pirzada, Shahidul Islam
No abstract text is available yet for this article.
September 2016: American Journal of Otolaryngology
Bjorn Cools, Filip Rega, Marc Gewillig
Percutaneous valved stent implantation is precluded in small infants because large delivery sheaths and large devices. We describe a procedure in a 1-year-old boy in whom a 19 mm Epic™ valve in tricuspid position had become dysfunctional. As the internal diameter of the prosthetic valve was about 16 mm, the only available valve was the Melody™ valved stent. Technical modifications were required to address issues like venous access, the bulky delivery system, and the length of the valved stent. The Melody™ valved stent was surgically trimmed and mounted on a 16 mm Tyshak balloon, access was provided transhepatically through a short 18 Fr sheath...
August 16, 2016: Catheterization and Cardiovascular Interventions
Lindsay R Freud, Gerald R Marx, Audrey C Marshall, Wayne Tworetzky, Sitaram M Emani
OBJECTIVES: Mitral valve replacement (MVR) in young children is limited by the lack of small prostheses. Our institution began performing MVR with modified, surgically placed, stented jugular vein grafts (Melody valve) in 2010. We sought to describe key echocardiographic features for pre- and postoperative assessment of this novel form of MVR. METHODS: The pre- and postoperative echocardiograms of 24 patients who underwent Melody MVR were reviewed. In addition to standard measurements, preoperative potential measurements of the mitral annulus were performed whereby dimensions were estimated for Melody sizing...
July 25, 2016: Journal of Thoracic and Cardiovascular Surgery
Ashish H Shah, Eric M Horlick, Andreas Eicken, Jeremy D Asnes, Martin L Bocks, Younes Boudjemline, Allison K Cabalka, Thomas E Fagan, Stephan Schubert, Vaikom S Mahadevan, Danny Dvir, Mark Osten, Doff B McElhinney
BACKGROUND: The most common reason for reintervention after a Björk modification of the Fontan procedure, in which the right ventricle (RV) is incorporated into the pulmonary circulation by connecting the right atrial (RA) appendage to the RV directly or with an extra-anatomic graft, is obstruction or regurgitation of the RA-RV connection. Transcatheter implantation of a valved stent is an appealing option for the treatment of RA-RV conduit dysfunction in these patients. In the present study, we assessed early and intermediate results after transcatheter valve implantation within an obstructed or regurgitant RA-RV modified Fontan pathway...
July 28, 2016: Catheterization and Cardiovascular Interventions
Bryant Priromprintr, Michael J Silka, Jonathan Rhodes, Anjan S Batra
BACKGROUND: Although percutaneous Melody valve implant has become an accepted alternative to surgical pulmonary valve replacement in patients with congenital heart disease (CHD), the benefit regarding frequency and severity of arrhythmias remains undefined. OBJECTIVE: This study evaluated the impact of Melody valve implant on the type and frequency of arrhythmias during cardiopulmonary exercise testing (CPET) and subsequent clinical outcome. METHODS: As part of the phase I Melody valve clinical trial, 136 patients with CHD underwent prospective serial evaluation including CPET prior to, 6 months after, and annually for 5 years...
July 21, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Hoang H Nguyen, David T Balzer, Joshua J Murphy, Ramzi Nicolas, Shabana Shahanavaz
This retrospective study aims to evaluate radiation exposure by three-dimensional rotational angiography (3DRA) during trans-catheter Melody pulmonary valve (TMPV) procedures. 3DRA has been reported to have added value in the management of complex congenital heart disease aiding in the performance of interventional procedures albeit with concerns of higher radiation exposure. We test the hypothesis that 3DRA does not cause additional radiation exposure during TMPV procedures. We analyzed all 81 TMPV procedures performed at St...
July 25, 2016: Pediatric Cardiology
Andrew E Schneider, Jeffrey W Delaney, Allison K Cabalka
Bioprosthetic valve thrombosis is an uncommon complication. We report two young women with prior uncomplicated percutaneous pulmonary valve replacement (Melody(®) , Medtronic, Inc. Minneapolis, MN) who later developed symptomatic pulmonary emboli and pulmonary valve dysfunction without evidence of infection. Thrombophilia risk factors included oral contraceptive use and mild thrombophilia. Both experienced recovery of valve function following anticoagulation. Acute changes in Melody(®) valve function should prompt a thorough investigation for and treatment of potential thrombotic causes...
July 20, 2016: Catheterization and Cardiovascular Interventions
Zakaria Jalal, Louise Galmiche, Christophe Beloin, Younes Boudjemline
BACKGROUND: Percutaneous pulmonary valve implantation (PPVI) using the bovine jugular vein Melody(®) valve (Medtronic Inc., Minneapolis, MN, USA) is safe and effective. However, post-procedural complications have been reported, the reasons for which are unclear. OBJECTIVE: To assess the impact of PPVI procedural steps on valvular histology and leaflet mechanical behaviour. METHODS: Three different valved stents (the Melody(®) valve and two homemade stents with bovine and porcine pericardium) were tested in vitro under four conditions: (1) control group; (2) crimping; (3) crimping plus inflation of low-pressure balloon; (4) condition III plus post-dilatation (high-pressure balloon)...
August 2016: Archives of Cardiovascular Diseases
Joanna Nozynska, Brigitte Stiller, Jochen Grohmann
Reconstructing the right ventricular outflow tract and pulmonary valve via a bovine-derived valve conduit such as Matrix-P-Xenograft is a common surgical repair technique for pulmonary atresia and ventricular septal defect. After conduit degeneration due to calcification or aneurysmal dilatation, percutaneous transvenous stenting of the right ventricular outflow tract followed by pulmonary valve implantation has become the standard interventional treatment. Applied to stenotic conduits, the method is considered safe and effective...
June 1, 2016: Catheterization and Cardiovascular Interventions
Brian A Boe, John E Rectenwald, Martin L Bocks
A 28-year-old male with single ventricular heart disease status post Fontan palliation and subsequent placement of left ventricle to ascending aorta (LV-AAo) valved conduit developed ascites and edema. Diagnostic catheterization revealed elevated ventricular end diastolic pressures (EDP) secondary to severe LV-AAo conduit regurgitation. Given the unique anatomy, surgical access via the right axillary artery provided optimal route for transcatheter valve implantation within the conduit. The procedure resulted in significant hemodynamic improvement with no complications...
May 17, 2016: Catheterization and Cardiovascular Interventions
Clare O'Donnell, Rhonda Holloway, Elizabeth Tilton, John Stirling, Kirsten Finucane, Nigel Wilson
BACKGROUND: Infective endocarditis has been reported post Melody percutaneous pulmonary valve implant; the incidence and risk factors, however, remain poorly defined. We identified four cases of endocarditis from our first 25 Melody implants. Our aim was to examine these cases in the context of postulated risk factors and directly compare endocarditis rates with local surgical valves. METHODS: We conducted a retrospective review of patients post Melody percutaneous pulmonary valve implant in New Zealand (October, 2009-May, 2015) and also reviewed the incidence of endocarditis in New Zealand among patients who have undergone surgical pulmonary valve implants...
May 10, 2016: Cardiology in the Young
Daniel S Levi, Sanjay Sinha, Morris M Salem, Jamil A Aboulhosn
BACKGROUND: While the Melody valve is unable to be used for replacement of large pulmonary outflow tracts, the 29 mm Sapien XT transcatheter valve, designed specifically for aortic valve replacement, can potentially be used in these large native outflow tracts. Techniques to enable off-label use of the Sapien XT valve for large-diameter pulmonary and tricuspid valve replacement are described. METHODS: Use of the Sapien valve for transcatheter pulmonary and tricuspid valve replacement using both the commercially available Novaflex+ system and using a novel flexible delivery system was reviewed...
September 2016: Catheterization and Cardiovascular Interventions
Haysam Baho, Jameel Atta, Amjad Kouatly, Alain Fraisse
Stent embolization is a complication that usually requires surgical extraction. We report a case where the covered stent used in MELODY valve trans-catheter pulmonary valve placement embolized to the right ventricle after being fully dilated on a 24-m-diameter balloon. After several unsuccessful attempts trying to capture it back or push it forward to the intended landing zone, we succeeded in deploying another stent straddling the embolized stent to anchor both of them in the main pulmonary artery. Two months later, we performed the valve implantation supported by both pre-stents...
June 2016: Pediatric Cardiology
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