Endovascular Melody valve-in-valve implantation with elective ECMO support reduced the transmitral gradient from 30 to 8 mmHg and maintained valve function at 3-year follow-up in a pediatric patient.
Case Report (n=1)
Is endovascular Melody valve-in-valve implantation with elective ECMO support feasible in an inoperable pediatric patient with a dysfunctional mitral bioprosthesis?
Melody valve-in-valve implantation with elective ECMO support is a feasible and viable rescue strategy for high-risk pediatric patients with dysfunctional mitral bioprostheses.
ABSTRACT Reoperation for dysfunctional mitral bioprostheses carries substantial risk. Endovascular valve-in-valve (V-in-V) implantation is an alternative, but pediatric experience is scarce. We report the feasibility of the Melody valve V-in-V with elective extracorporeal membrane oxygenation (ECMO) support in an inoperable pediatric patient. A transvenous antegrade, transesophageal echocardiography–guided procedure was performed with venoarterial ECMO. The transmitral gradient fell from 30 to 8 mmHg without paravalvular leak or left-ventricular outflow obstruction. ECMO was discontinued within 24 h. At 3-year follow-up, valve function remains preserved, and the patient is stable. Melody V-in-V with elective ECMO is a viable rescue strategy for high-risk pediatric candidates.
Santiago et al. (Sun,) conducted a case report in Dysfunctional mitral bioprosthesis (n=1). Melody valve valve-in-valve implantation with elective ECMO support was evaluated on Transmitral gradient and clinical stability. Endovascular Melody valve-in-valve implantation with elective ECMO support reduced the transmitral gradient from 30 to 8 mmHg and maintained valve function at 3-year follow-up in a pediatric patient.