Melody pulmonary valve

Case contributed by Dr Jayanth Keshavamurthy

Presentation

Patient born with tetralogy of the Fallot. Surgically corrected VSD and bioprosthetic pulmonary valve had shortness of breath. Had a pulmonary valve replacement.

Patient Data

Age: 22
Gender: Male
X-ray

Sternotomy wires 2 kinds.

VSD repair first.

Bioprostheic valve in a RVOT conduit.

Post op image showing the percutaneously placed Melody valve on top of the older valve.

Case Discussion

CONCLUSIONS of Cardiac MRI prior to Melody valve placement:
1. Patient born with tetralogy of the Fallot. Surgically corrected VSD and prosthetic pulmonary valve are seen. 5 vessel aortic arch with a retroesophageal course of the right subclavian artery arising from the descending thoracic aorta.

2. RVOT measures 38 mm in the maximal dimension.The main pulmonary artery measures 24 mm in the maximum dimension.Right and left pulmonary arteries are measuring 21 and 24 mm in
diameter.

3. Right ventricle: Right ventricular dilatation, right ventricularhypertrophy, RV end diastolic volume index at least 135 mL. RV ejection fraction 53%.

3. Valvular function: Severe pulmonary regurgitation of the prosthetic pulmonary valve (57%).

4. Delayed enhancement: none seen.

So a melody valve has been placed.

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Case information

rID: 40991
Case created: 10th Nov 2015
Last edited: 15th Dec 2016
Inclusion in quiz mode: Included

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