Medtronic Melody Transcatheter Pulmonary Valve

by James P. Kyser, M.D.

The Medtronic Melody transcatheter pulmonary valve is the first and only FDA approved catheter-placed heart valve in pediatrics. We have been using this valve in our hospital since shortly after its FDA release to the United States. This new transcatheter heart valve has made tremendous improvements in our medical care for our patients, as now we can place a heart valve in the cath lab through the a vessel in the groin and spare them open-heart surgery.

Many patients have significant congenital heart disease that will require multiple surgeries in their lifetime. Many of these repeat surgeries will require multiple replacements of the pulmonary valve over their lifetime. This requires open-heart surgery, going on bypass, the possible exposure to additional blood products, an ICU stay, and 4-7 day hospital stay.

Now with this new Medtronic Melody transcatheter pulmonary valve, we are able to place many of these valves in the cath lab and dramatically cut down on the number of redo open heart surgeries. Rather than going to the operating room, the patient can go to the catheterization laboratory.

We can access the vein in the leg, and through a long catheter, insert the valve on a balloon-expandable stent. We deploy the stent in the pulmonary valve position, which expands the valve. The valve leaflets are then free to open and close normally inside the stent. All the catheters are then removed from the body and the catheterization site is a small puncture site at the hip, requiring no stitches. The patient is observed overnight in the hospital and walks out of the hospital the following morning.

With this transcatheter pulmonary valve, we are able to treat patients who have postsurgical blocked pulmonary valves or leaky valves or a combination of both.  We have had a great deal of success with this procedure at our institution, treating this population of patients.  The patients commonly report that they can feel the function of the new valve immediately upon waking up as their heart becomes much more efficient with a new competent, unblocked pulmonary valve.  Upon completion, the family and the patient are frequently surprised and amazed at how minimally invasive the procedure truly is. They are even more amazed that they are able to walk out of the hospital the following morning.