title: Melody valve implantation within freestyle stentless porcine aortic heterograft.
abstract: BACKGROUND
  The Melody transcatheter pulmonary valve has been implanted successfully worldwide since its first implant in 2000. The vast majority of these valves have been implanted in pulmonary homografts. In our institution, the most common valve used for pulmonary valve replacement is the Medtronic Freestyle stentless porcine aortic heterograft.
  
  
  OBJECTIVE
  We describe our experience implanting the Melody valve within the Freestyle heterograft.
  
  
  METHODS
  Retrospective chart review was performed.
  
  
  RESULTS
  Between June 2012 and June 2015, 19 Melody valves were placed within Freestyle heterografts. The most common indication for intervention was pulmonary stenosis. Following pre-stent and Melody valve implantation, right ventricle-to-pulmonary artery gradient decreased from 38.1 ± 12.1 to 10 ± 4.7 mm Hg (P < 0.001), and right ventricular pressure decreased from 61.7 ± 17.8 to 35.6 ± 10.2 mm Hg (P < 0.001). Two procedural adverse events occurred. At median follow-up of 24 months (range 2-48 months), no patients had mean right ventricular outflow tract gradients >30 mm Hg or worse than mild insufficiency. No valve reinterventions have been necessary and no episodes of endocarditis have been observed.
  
  
  CONCLUSIONS
  The Melody valve can be implanted successfully within a stentless aortic bioprosthesis with good short- and intermediate-term longevity. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Cook Children's Medical Center, Fort Worth, Texas.
authors.forename: James A
authors.initials: JA
authors.lastname: Kuo
authors.affiliation: University of North Texas Health Sciences Center, Fort Worth, Texas.
authors.forename: Ashlea A
authors.initials: AA
authors.lastname: Feezel
authors.affiliation: Cook Children's Medical Center, Fort Worth, Texas.
authors.forename: Traci N
authors.initials: TN
authors.lastname: Putnam
authors.affiliation: Cook Children's Medical Center, Fort Worth, Texas.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Schutte
mesh_terms: D000818:Animals; D001011:Aorta / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D017023:Coronary Angiography; D006330:Heart Defects, Congenital / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation*; D064593:Heterografts; D011474:Prosthesis Design; D011664:Pulmonary Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011666:Pulmonary Valve Stenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D034421:Sus scrofa; D013997:Time Factors; D016896:Treatment Outcome
keywords: bioprosthetic valve; congenital heart defects; percutaneous pulmonary valve implantation