70. Surgical mitral valve replacement with modified Melody valve in children
We describe a case of mitral valve (MV) replacement using modified Melody valve implantation. Methods: A 2.5 year-old girl,with a history of ALCAPA repair in April 2012, had undergone MV repair by ring annuloplasty at 1 year of age. She came back with severe MV stenosis (mean gradient, 8 mmHg) and r...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Saudi Heart Association
2015-10-01
|
| Series: | Journal of the Saudi Heart Association |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1016731515003103 |
| _version_ | 1818520546446409728 |
|---|---|
| author | Ahmed Badr Elwy N. Albahlooli H. Hamid Y. Al Fariedi K. AlKhalaf A. Al Sahari A. Al Otay K. Al Najashi R.M. Di Donato |
| author_facet | Ahmed Badr Elwy N. Albahlooli H. Hamid Y. Al Fariedi K. AlKhalaf A. Al Sahari A. Al Otay K. Al Najashi R.M. Di Donato |
| author_sort | Ahmed Badr Elwy |
| collection | DOAJ |
| description | We describe a case of mitral valve (MV) replacement using modified Melody valve implantation.
Methods: A 2.5 year-old girl,with a history of ALCAPA repair in April 2012, had undergone MV repair by ring annuloplasty at 1 year of age. She came back with severe MV stenosis (mean gradient, 8 mmHg) and regurgitation. She had a hugely dilated left atrium and a MV annulus of 14 mm. She, then, underwent surgical MV replacement with a modified Melody valve.
Results: The Melody valve was prepared before the cardiopulmonary bypass. The procedure included stent shortening and adding a bovine pericardial sewing ring. Through a trans-septal approach, the previous MV ring was removed, the pericardial ring patch of the Melody valve was secured to the mitral annulus and the ventricular end of the valve was fixed to the posterior–inferior wall of the left ventricle. The prosthesis was then inflated to size 16 mm. Testing of the valve showed good leaflet coaptation. The atrial septum was closed by fenestrated (4 mm) bovine pericardial patch. TEE showed good valve function with a tiny paravalvular leak and no left ventricular outflow obstruction. The pulmonary veins were also unobstructed.
Conclusions: The modified Melody valve is a viable option for children MV annular diameters, providing a valid alternative to existing prostheses. The technique is relatively easy and the short term result is very good. This prosthesis will be particularly attractive if maintaining competence after subsequent dilations as the child grows. |
| first_indexed | 2024-12-11T01:38:57Z |
| format | Article |
| id | doaj.art-911ced1a9b014c1a9dda9826cd40e9a0 |
| institution | Directory Open Access Journal |
| issn | 1016-7315 |
| language | English |
| last_indexed | 2024-12-11T01:38:57Z |
| publishDate | 2015-10-01 |
| publisher | Saudi Heart Association |
| record_format | Article |
| series | Journal of the Saudi Heart Association |
| spelling | doaj.art-911ced1a9b014c1a9dda9826cd40e9a02022-12-22T01:25:06ZengSaudi Heart AssociationJournal of the Saudi Heart Association1016-73152015-10-0127432610.1016/j.jsha.2015.05.25170. Surgical mitral valve replacement with modified Melody valve in childrenAhmed Badr ElwyN. AlbahlooliH. HamidY. Al FariediK. AlKhalafA. Al SahariA. Al OtayK. Al NajashiR.M. Di DonatoWe describe a case of mitral valve (MV) replacement using modified Melody valve implantation. Methods: A 2.5 year-old girl,with a history of ALCAPA repair in April 2012, had undergone MV repair by ring annuloplasty at 1 year of age. She came back with severe MV stenosis (mean gradient, 8 mmHg) and regurgitation. She had a hugely dilated left atrium and a MV annulus of 14 mm. She, then, underwent surgical MV replacement with a modified Melody valve. Results: The Melody valve was prepared before the cardiopulmonary bypass. The procedure included stent shortening and adding a bovine pericardial sewing ring. Through a trans-septal approach, the previous MV ring was removed, the pericardial ring patch of the Melody valve was secured to the mitral annulus and the ventricular end of the valve was fixed to the posterior–inferior wall of the left ventricle. The prosthesis was then inflated to size 16 mm. Testing of the valve showed good leaflet coaptation. The atrial septum was closed by fenestrated (4 mm) bovine pericardial patch. TEE showed good valve function with a tiny paravalvular leak and no left ventricular outflow obstruction. The pulmonary veins were also unobstructed. Conclusions: The modified Melody valve is a viable option for children MV annular diameters, providing a valid alternative to existing prostheses. The technique is relatively easy and the short term result is very good. This prosthesis will be particularly attractive if maintaining competence after subsequent dilations as the child grows.http://www.sciencedirect.com/science/article/pii/S1016731515003103 |
| spellingShingle | Ahmed Badr Elwy N. Albahlooli H. Hamid Y. Al Fariedi K. AlKhalaf A. Al Sahari A. Al Otay K. Al Najashi R.M. Di Donato 70. Surgical mitral valve replacement with modified Melody valve in children Journal of the Saudi Heart Association |
| title | 70. Surgical mitral valve replacement with modified Melody valve in children |
| title_full | 70. Surgical mitral valve replacement with modified Melody valve in children |
| title_fullStr | 70. Surgical mitral valve replacement with modified Melody valve in children |
| title_full_unstemmed | 70. Surgical mitral valve replacement with modified Melody valve in children |
| title_short | 70. Surgical mitral valve replacement with modified Melody valve in children |
| title_sort | 70 surgical mitral valve replacement with modified melody valve in children |
| url | http://www.sciencedirect.com/science/article/pii/S1016731515003103 |
| work_keys_str_mv | AT ahmedbadrelwy 70surgicalmitralvalvereplacementwithmodifiedmelodyvalveinchildren AT nalbahlooli 70surgicalmitralvalvereplacementwithmodifiedmelodyvalveinchildren AT hhamid 70surgicalmitralvalvereplacementwithmodifiedmelodyvalveinchildren AT yalfariedi 70surgicalmitralvalvereplacementwithmodifiedmelodyvalveinchildren AT kalkhalaf 70surgicalmitralvalvereplacementwithmodifiedmelodyvalveinchildren AT aalsahari 70surgicalmitralvalvereplacementwithmodifiedmelodyvalveinchildren AT aalotay 70surgicalmitralvalvereplacementwithmodifiedmelodyvalveinchildren AT kalnajashi 70surgicalmitralvalvereplacementwithmodifiedmelodyvalveinchildren AT rmdidonato 70surgicalmitralvalvereplacementwithmodifiedmelodyvalveinchildren |