Annals of Pediatric Cardiology · Published 2025-01-01 · Journal article · DOI 10.4103/apc.apc_239_25
Reoperation for dysfunctional mitral bioprostheses carries substantial risk. Endovascular valve-in-valve (V-in-V) implantation is an alternative, but pediatric experience is scarce. We report the feasibility of the Melody valve V-in-V with elective extracorporeal membrane oxygenation (ECMO) support in an inoperable pediatric patient. A transvenous antegrade, transesophageal echocardiography–guided procedure was performed with venoarterial ECMO. The transmitral gradient fell from 30 to 8 mmHg without paravalvular leak or left-ventricular outflow obstruction. ECMO was discontinued within 24 h. At 3-year follow-up, valve function remains preserved, and the patient is stable. Melody V-in-V with elective ECMO is a viable rescue strategy for high-risk pediatric candidates.
Abstract from DOAJ. Public domain (CC0 1.0).
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