OBJECTIVE Pulmonary valve replacement is performed increasingly late after correction of Tetralogy of Fallot. Most reports deal with pulmonary allografts as the valvar substitute of choice, although late deterioration and reoperation(s) are the rule. Mechanical valves are scarcely reported and if so only because of complications. Although life-long anticoagulation therapy is indicated for mecha...

SEE PAGE 2858 T he perfect heart valve substitute has not yet been developed and matching the patient to existing options to optimize survival and reduce valve-related complications remains challenging. The choices for aortic valve replacement (AVR) are mechanical valves, bioprosthetic valves, and biological valves such as aortic valve homograft and the Ross procedure (pulmonary autograft). The...

Pulmonary valve stenosis was relieved by balloon dilatation during cardiac catheterisation on 27 occasions in 23 infants and children aged 7 days to 12 years, median 31 months (three aged less than 2 weeks). Pulmonary valve diameter was estimated by cross sectional echocardiography to assist in the choice of balloon size. Before dilatation the right ventricular systolic pressure ranged from 41 ...

Pulmonary autograft replacement of the aortic valve, the “Ross procedure,” involves transplantation of the native pulmonary valve into the aortic position and reconstruction of the right ventricular outflow tract with a cryopreserved pulmonary or aortic homograft. In any surgeon’s hands this operation is technically challenging and successful performance of the Ross procedure requires strategie...

BACKGROUND The Melody valve is approved for percutaneous pulmonary valve replacement in dysfunctional right ventricular outflow tracts. The function of this valve when subjected to high-pressure loads in humans is unknown. The aim of this study was to describe the immediate and short-term results of Melody valves implanted in a high-pressure environment. METHODS AND RESULTS Definitions of a h...

Seven patients with advanced mitral valve disease and systemic pulmonary hypertension subjected to mitral valve replacement without survival are presented here with the common denominator or the characteristic additional finding of aneurysmal dilatation of the pulmonary artery. During the same period 16 other patients with similar degree of valvular dysfunction and systemic pulmonary hypertensi...

Diffuse alveolar hemorrhage (DAH) can be caused by several etiologies including vasculitis, drug exposure, anticoagulants, infections, mitral valve stenosis, and regurgitation. Chronic mitral valve regurgitation (MR) has been well documented as an etiological factor for DAH, but there have been only a few cases which have reported acute mitral valve regurgitation as an etiology of DAH. Acute mi...

BACKGROUND Transcatheter pulmonary valve implantation using the Melody valve has emerged as an important therapy for the treatment of postoperative right ventricular outflow tract dysfunction. Melody-in-bioprosthetic valves (BPV) is currently considered an off-label indication. We review the combined experience with transcatheter pulmonary valve implantation within BPVs from 8 centers in the Un...