Key result
Transhepatic access enables percutaneous Melody Valve dilatation when femoral venous access is impossible.
Why the study?
Patients with complex congenital heart disease and surgically implanted Melody valves may develop vascular complications that limit standard percutaneous access, necessitating alternative approaches.
Case Report (n=1)
Transhepatic access provides a viable alternative for percutaneous transseptal interventions in pediatric patients with complex congenital heart disease and femoral venous thrombosis.
May support transhepatic access in select toddlers with femoral occlusion; hypothesis-generating and should not yet change practice.
(Medtronic, Minneapolis, MN, USA) biological prosthesis in mitral position has shown acceptable short-term results. Furthermore, it allows its expansion with a balloon when the patient grows up, and this procedure can be performed by a venous catheterization through transseptal approach through an interatrial communication or puncturing the septum. Patients with complex congenital heart disease undergoing multiple surgical and percutaneous interventions may present with vascular complications such as thrombosis of the femoral venous system that make percutaneous access impossible. In this situation, the transhepatic approach is a very useful alternative to access the heart.
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Torre et al. (2022) conducted a case report in Complex congenital heart disease with femoral venous thrombosis (n=1). Percutaneous transhepatic and transseptal dilatation was evaluated. The transhepatic approach is a useful alternative for percutaneous transseptal dilatation of a surgically implanted Melody Valve in a 2-year-old child when femoral venous access is impossible.
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