A new percutaneous pulmonary valve implantation technique for complex right ventricular outflow tracts: The ‘Folded Melody® Valve’ - 24/08/14
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Résumé |
Objectives |
This article sought to describe a new modification of the Melody® valve that allows percutaneous pulmonary valve implantation (PPVI) in complex outflow tracts.
Background |
PPVI has been validated as a valuable therapeutic option for the management of patients with dysfunctional right ventricular outflow tracts (RVOT). However, complex and unfavorable RVOT anatomy continue to limit the indications for PPVI.
Methods |
Between April 2012 and November 2013, PPVI was performed in 10 patients (mean age=16,3±5years old) using a new modification of the Melody® valve consisting in a manual shortening of the Melody by folding the 2 extremities of the stent. We reviewed the results of this technique.
Results |
Indications were short RVOT in 3 patients, prevention of retrosternal compression in 2 patients, bioprosthetic valves in 4 and coronary arteries proximity in one. No complication occurred during procedures. All patients had excellent hemodynamic results (mean post PPVI RV-PA gradient was 14±6mmHg, 3 patients had trivial pulmonary regurgitation (PR) and the remaining had no PR). After a mean follow-up of 8months (range 2–18months), no patient had reintervention. No valve dysfunction or stent fractures were observed (Fig. 1A and B).
Conclusion |
The ‘Folded valve technique’ is a safe modification of the Melody® valve. By shortening the valve, this technique allowed PPVI in short and complex RVOTs with vulnerable neighbourhood.
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Vol 107 - N° 8-9
P. 487 - août 2014 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.