Right ventricular outfl ow tract revalvulation using the Melody Valve: The next frontier

Abstract

Right ventricular outfl ow tract revalvulation using the Melody Valve: The next frontier in terms of years of freedom from re-operation. Freedom from re-operation varies (see Table I) with rates of 97% at one year to, on average, 70% and 31% after 10 and 15 years respectively.(1-3) Low body weight, younger age at insertion, small size grafts and longer cross-clamping times are factors associated with early graft failure.(1,4) It has been estimated that these patients may require up to 5 conduit revisions over a lifetime.Multiple conduit revisions in these patients often result in prolonged hospital stays, increased morbidity and mortality due to the fact that difficulty of surgery increases with every re-operation. This may result in a considerable increase in medical costs and a negative impact on quality of life. Nevertheless, surgery has good long term survival and should be considered as the gold standard of treatment. PERCUTANEOUS RVOT REVALVULATIONUntil recently, surgery was the only option for managing RVOT dysfunction. The first percutaneous pulmonary valve was implanted