Case Report of Melody Valve Placement to Treat Neoaortic Valve Stenosis in an Adult With Fontan Circulation

Figures

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  Figure 1. Frontal projection from cardiac computed tomography showing the native aorta and its connection with the neoaortic hemashield graft. The graft measures 18 mm in diameter. The neoaortic valve is seen with thickened leaflets.

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  Figure 2. Anteroposterior view of aortic angiogram showing the native aorta and its connection with the neoaortic graft.

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  Figure 3. Anteriorposterior view of aortic angiogram prior to expansion of the Melody valve. A Melody valve and bare metal Palmaz stent have been crimped onto the 22-mm delivery ensemble, and the ensemble has been advanced retrograde over a Safari wire across the neoaortic valve. The valve is positioned to extend into the right ventricle to effectively pin or bridge the abnormal neoaortic valve leaflets. The valve will be anchored in the hemashield neoaortic graft but will not obstruct flow into the native aorta.

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  Figure 4. Anteroposterior view of aortic angiogram after transcatheter replacement of the Melody valve in the neoaortic position showing that the stenotic neoaortic valve leaflets are bridged with the Melody valve. There is no neoaortic valve regurgitation.

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  Figure 5. Anteriorposterior view of a right ventricular angiogram after transcatheter replacement of the Melody valve in the neoaortic position showing that the stenotic neoaortic valve leaflets are bridged with the Melody valve. The Melody valve is well-seated in the neoaortic graft.