title: Surgical mitral valve replacement with the Melody valve in infants and children: the Italian experience.
abstract: OBJECTIVE
  Paediatric patients with mitral valve (MV) disease have limited options for prosthetic MV replacement. Based on long experience with the stented bovine jugular vein graft (Melody valve) in the right ventricular outflow tract, we aimed to test the use of the Melody valve as a surgical implant in the mitral position in a small group of infants with congenital mitral disease.
  
  
  RESULTS
  Eight patients, aged from 3 months to 6.2 years, with congenital MV dysplasia underwent Melody valve implantation in the mitral position between March 2014 and October 2015. Once sutured to the MV annulus, the Melody valve was expanded through a balloon catheter to achieve the best diameter (12-20 mm). Two patients needed ECMO assistance after traditional MV repair and a Melody valve was successfully implanted as possible bail-out. However, neither of them recovered from multi-organ failure and both died, in spite of the well-functioning Melody prosthesis. During follow-up, only one patient underwent catheter-based balloon expansion of the valve.
  
  
  CONCLUSIONS
  The medium-term results of this procedure are encouraging. The Melody valve opens up the opportunity to carry out MV replacement in more children at an earlier time point, and it has potential to revolutionise the treatment of MV disease.
authors.affiliation: Department of Paediatric Cardiac Surgery, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Frigiola
authors.forename: Francesca Romana
authors.initials: FR
authors.lastname: Pluchinotta
authors.forename: Antonio
authors.initials: A
authors.lastname: Saracino
authors.forename: Alessandro
authors.initials: A
authors.lastname: Giamberti
authors.forename: Carmelo
authors.initials: C
authors.lastname: Arcidiacono
authors.forename: Luciane
authors.initials: L
authors.lastname: Piazza
authors.forename: Matteo
authors.initials: M
authors.lastname: Reali
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Butera
authors.forename: Alessandro
authors.initials: A
authors.lastname: Varrica
authors.forename: Mario
authors.initials: M
authors.lastname: Carminati
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007223:Infant; D007558:Italy; D008297:Male; D008943:Mitral Valve; D012189:Retrospective Studies