title: Short-term performance of the transcatheter Melody valve in high-pressure hemodynamic environments in the pulmonary and systemic circulations.
abstract: BACKGROUND
  The Melody valve is approved for percutaneous pulmonary valve replacement in dysfunctional right ventricular outflow tracts. The function of this valve when subjected to high-pressure loads in humans is unknown. The aim of this study was to describe the immediate and short-term results of Melody valves implanted in a high-pressure environment.
  
  
  RESULTS
  Definitions of a high-pressure system were established for Melody valves implanted in the systemic (ie, aortic or mitral position) and pulmonary (ie, right ventricular outflow tract conduit or tricuspid valve annulus) circulations. Implants in these environments were ascertained from databases of the 5 centers that participated in the US Investigational Device Exemption trial. Thirty implants met the inclusion criteria: 23 pulmonary circulation implants (all in the pulmonary position) systemic circulation implants (5 in the native aortic position, 1 in a left ventricle-to-descending aorta conduit, and 1 in the mitral annulus). All pulmonary circulation implants were performed percutaneously in the catheterization laboratory. A hybrid approach (surgical exposure for transcatheter implant) was used for 4 of the aortic implants. There were no procedure-related deaths. Three patients died of nonprocedure- and nonvalve-related causes. At 1 year, freedom from moderate to severe regurgitation was 100%, and freedom from mild regurgitation was 90%. Freedom from moderate to severe stenosis was 86% at 1 year.
  
  
  CONCLUSIONS
  Short-term performance of the Melody valve in high-pressure environments is encouraging, with good valve function in all patients.
authors.affiliation: Department of Cardiology, Children’s Hospital, 300 Longwood Ave., Boston, MA 02115, USA.
authors.forename: Babar S
authors.initials: BS
authors.lastname: Hasan
authors.forename: Doff B
authors.initials: DB
authors.lastname: McElhinney
authors.forename: David W
authors.initials: DW
authors.lastname: Brown
authors.forename: John P
authors.initials: JP
authors.lastname: Cheatham
authors.forename: Julie A
authors.initials: JA
authors.lastname: Vincent
authors.forename: William E
authors.initials: WE
authors.lastname: Hellenbrand
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Jones
authors.forename: Evan M
authors.initials: EM
authors.lastname: Zahn
authors.forename: James E
authors.initials: JE
authors.lastname: Lock
mesh_terms: D000293:Adolescent; D000368:Aged; D001021:Aortic Valve / Q000503:physiopathology; D001775:Blood Circulation / Q000502:physiology*; D006328:Cardiac Catheterization / Q000379:methods; D002675:Child, Preschool; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007223:Infant; D008943:Mitral Valve / Q000503:physiopathology; D011652:Pulmonary Circulation / Q000502:physiology*; D011664:Pulmonary Valve / Q000503:physiopathology; D012039:Regional Blood Flow / Q000502:physiology*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D018497:Ventricular Dysfunction, Right / Q000503:physiopathology / Q000628:therapy*; D055815:Young Adult