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Patients with certain types of congenital heart disease, such as variants of tetralogy of fallot, may have surgical repair with the placement of a valved conduit (tube containing a valve) between the right side of the heart (right ventricle) and the arteries directing blood to the lungs (pulmonary arteries).

Over time, the valved conduit frequently fails, with degeneration of the valve within it, leading to leakage of pumped blood back from the lungs through the valved conduit to the right side of the heart. This can lead to excess stress on the heart and ultimately heart failure and heart rhythm problems.

Previously, the only option for patients with failing conduits was to have them replaced with an open heart surgery approach. While effective, this approach can be complicated by scar tissue from previous open heart surgeries.

New Valve Option

Recently the Melody valve has been approved by the FDA for implantation into failed right ventricle-to-pulmonary artery conduits. This valve is implanted by using a catheter introduced from a small incision on the blood vessel in the leg and threaded up to the heart. The Melody valve pushes aside the diseased pulmonary valve, and allows unobstructed blood flow from the heart to the lungs without the patient having to undergo traditional open heart surgery.

Who Is Eligible?

The Melody valve is indicated for patients with failed right ventricle-to-pulmonary artery conduits.  Patients without such conduits are not candidates for the Melody valve.

Evaluation for Percutaneous Pulmonary Valve Insertion

Tests may include:

• Chest x-ray
• Electrocardiogram (ECG, EKG)
• Echocardiogram
• Cardiac
• CT angiography
  

About the Procedure

Patients undergoing transcatheter pulmonary valve replacement with the Melody valve have a cardiac catheterization, which allows the doctor to see the diseased pulmonary valve and guide the placement of the Melody valve.

To insert the Melody valve, an incision is made in the leg to allow placement of a catheter into the blood vessels. The Melody valve is crimped onto a balloon at the end of that catheter. When the Melody valve is in position across the old diseased valve in the right ventricle-to-pulmonary artery conduit, the balloon is inflated to expand the Melody valve into position and moving the diseased valve out of the way. Following Melody valve insertion, the catheter is removed so the patient can be recovering.