Treatment of severe pulmonary insufficiency with bilateral branch pulmonary artery Melody valve implantation

Abstract

Branch pulmonary artery valve implantation has been reported in larger patients with dysfunctional right ventricular outflow tracts via routine femoral access. Here, we report treatment of severe pulmonary insufficiency with bilateral branch pulmonary artery Melody valve implantation (Medtronic, Minneapolis, Minnesota). To the best of our knowledge, this is the first report of bilateral valve implantation utilising the hybrid approach in a small-size patient.

Bilateral Harmony™ valve placement in branch pulmonary arteries

“…valves such as Melody and Sapien valves. 4,[9][10][11] To our knowledge, this is the first reported case of bilateral Harmony™ valve placement in the bilateral branch pulmonary arteries.…”

“…It was first described using the Melody valve in an ovine model as a proof of principle 8 . Different valves have been used, but they have all been balloon‐expanding valves such as Melody and Sapien valves 4,9‐11 . To our knowledge, this is the first reported case of bilateral Harmony™ valve placement in the bilateral branch pulmonary arteries.…”

“…Modifying the RVOT via a hybrid approach can be an alternative, but this option can also be limited in certain patients. [4][5][6][7] In this report, we describe a case in whom a surgical modification of the RVOT via a hybrid approach failed with the subsequent successful placement of two Harmony™ valves in the bilateral branch pulmonary arteries.…”

“…However, a group of patients with severe RVOT dilatation remains challenging, as even self‐expanding valves may not be safely placed due to inadequate interference with the RVOT. Modifying the RVOT via a hybrid approach can be an alternative, but this option can also be limited in certain patients 4‐7 …”