Transhepatic implant of a trimmed Melody™ valved stent in tricuspid position in a 1-year-old infant.
Percutaneous valved stent implantation is precluded in small infants because large delivery sheaths and large devices. We describe a procedure in a 1-year-old boy in whom a 19 mm Epic™ valve in tricuspid position had become dysfunctional. As the internal diameter of the prosthetic valve was about 16 mm, the only available valve was the Melody™ valved stent. Technical modifications were required to address issues like venous access, the bulky delivery system, and the length of the valved stent. The Melody™ valved stent was surgically trimmed and mounted on a 16 mm Tyshak balloon, access was provided transhepatically through a short 18 Fr sheath. After deployment, the intrahepatic route was sealed with two vascular plugs (8 and 10 mm) in tandem. The procedure was uncomplicated with perfect valve function 18 months after implant. © 2016 Wiley Periodicals, Inc.
['Cools|Bjorn|B|', 'Rega|Filip|F|', 'Gewillig|Marc|M|']
D063126:Balloon Valvuloplasty D001705:Bioprosthesis D006328:Cardiac Catheterization D058385:Cardiac Valve Annuloplasty D002406:Catheterization, Peripheral D018618:Echocardiography, Doppler, Color D018619:Echocardiography, Doppler, Pulsed D006350:Heart Valve Prosthesis D019918:Heart Valve Prosthesis Implantation D006503:Hepatic Veins D006801:Humans D007223:Infant D008297:Male D011474:Prosthesis Design D011475:Prosthesis Failure D011677:Punctures D020127:Recovery of Function D012008:Recurrence D015607:Stents D013997:Time Factors D016896:Treatment Outcome D014261:Tricuspid Valve D014262:Tricuspid Valve Insufficiency D014264:Tricuspid Valve Stenosis
congenital heart disease pediatric intervention surgery transcatheter valve implantation valvular