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Melody valve-in-valve implantation in the tricuspid position through a Fontan conduit fenestration


1 Department of Pediatric Cardiology, The Heart Program, Nicklaus Children's Hospital; Department of Pediatrics, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
2 Department of Pediatric Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio, USA

Correspondence Address:
Dr. Daniel Duarte
Heart Program at Nicklaus Children's Hospital, 3100 S.W. 62nd Ave., Miami, Florida, 33155
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/apc.apc_71_21

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Year : 2022  |  Volume : 15  |  Issue : 2  |  Page : 180-182

 

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Patients with single right ventricle and tricuspid regurgitation have increased morbidity and mortality rates. The outcomes of surgical tricuspid valve repair and replacement are dismal. Although some centers prefer valve replacement with a bioprosthetic valve in the tricuspid position for the pediatric population, these valves have limited longevity and will eventually need to be replaced. Unfortunately, single ventricle patients are fragile and unlikely to tolerate a second replacement. Percutaneous valve-in-valve (ViV) implantation is an acceptable alternative with low morbidity and mortality. Studies have also shown acceptable short- and mid-term outcomes. We report a case of Melody ViV placement in the tricuspid position in a patient with hypoplastic left heart syndrome through the fenestration of a Fontan conduit.






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1 Department of Pediatric Cardiology, The Heart Program, Nicklaus Children's Hospital; Department of Pediatrics, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
2 Department of Pediatric Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio, USA

Correspondence Address:
Dr. Daniel Duarte
Heart Program at Nicklaus Children's Hospital, 3100 S.W. 62nd Ave., Miami, Florida, 33155
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/apc.apc_71_21

Rights and Permissions

Patients with single right ventricle and tricuspid regurgitation have increased morbidity and mortality rates. The outcomes of surgical tricuspid valve repair and replacement are dismal. Although some centers prefer valve replacement with a bioprosthetic valve in the tricuspid position for the pediatric population, these valves have limited longevity and will eventually need to be replaced. Unfortunately, single ventricle patients are fragile and unlikely to tolerate a second replacement. Percutaneous valve-in-valve (ViV) implantation is an acceptable alternative with low morbidity and mortality. Studies have also shown acceptable short- and mid-term outcomes. We report a case of Melody ViV placement in the tricuspid position in a patient with hypoplastic left heart syndrome through the fenestration of a Fontan conduit.






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