A hybrid technique using a transcatheter valve mounted on an annuloplasty ring can successfully replace a dysfunctional mechanical mitral valve in a pediatric patient.
Hybrid mitral valve replacement may offer a pediatric bailout option; leaves open durability and applicability questions.
An 11-year old boy, with complex left ventricular morphology in the setting of repaired double outlet right ventricle developed progressive mitral regurgitation leading to a repair which failed, necessitating replacement of the valve with a 21 mm St. Jude mechanical prosthesis. He represented 3 weeks later in extremis with signs of severe mitral stenosis. The valve was replaced via a hybrid technique with a 26 mm Edwards Sapien 3 valve mounted on a MEMO 3D annuloplasty ring. One year later, the valve is functioning well with no regurgitation or evidence of an inflow gradient.
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Murphy et al. (2016) studied this question.
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