Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun;46(5):1218-1226.
doi: 10.1007/s00246-024-03538-1. Epub 2024 Jun 22.

Predictors of Valve Failure Following Surgical Atrioventricular Valve Replacement with a Melody Valve in Infants and Children

Samantha Gilg  1 , Jeffrey Delaney  2 , Christopher Curzon  2 , David Danford  2 , Ali Ibrahimiye  3 , Aswathy Vaikom House  4 , James Hammel  5
Affiliations

Predictors of Valve Failure Following Surgical Atrioventricular Valve Replacement with a Melody Valve in Infants and Children

Samantha Gilg et al. Pediatr Cardiol. 2025 Jun.

Abstract

Options for atrioventricular (AV) valve replacement in small pediatric patients are very limited. The Melody valve has shown reasonable short-term outcomes. This study was aimed at identifying predictors of valve failure following AV valve replacement with a Melody valve at a single-center. 26 patients underwent 37 AV valve replacements with 31/37 (84%) of valves placed in the systemic AV valve position. Median age at procedure was 17 months (IQR 4-33) and weight was 8.5 kg (IQR 6.25-12.85). Median balloon size for valve implant was 20 mm (IQR 18-22). Repeat intervention occurred in 21 cases (57%) with repeat surgery in all but one. Median freedom from re-intervention was 31 months; 19% were free from re-intervention at 60 months. Age < 12 months weight < 10 kg and BSA < 0.4 m2 were all significant risk factors for early valve failure (p = 0.003, p 0.017, p 0.025, respectively). Valve longevity was greatest with balloon inflation to diameter 1.20-1.35 times the patient's expected annular diameter (Z0), relative to both smaller or larger balloons (p = 0.038). In patients less than 12 months of age, patients with single ventricle physiology had an increased risk of early valve failure (p = 0.004).

Keywords: Atrioventricular valve replacement; Melody valve; Pediatric.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing Interests: The authors have no relevant financial or non-financial interests to disclose.

References

    1. Caldarone CA, Raghuveer G, Hills CB, Atkins DL, Burns TL, Behrendt DM, Moller JH (2001) Long-term survival after mitral valve replacement in children aged <5 years: a multi-institutional study. Circulation 104(12 Suppl 1):I143–I147. https://doi.org/10.1161/hc37t1.094840 - DOI - PubMed
    1. Eble BK, Fiser WP, Simpson P, Dugan J, Drummond-Webb JJ, Yetman AT (2003) Mitral valve replacement in children: predictors of long-term outcome. Ann Thorac Surg 76(3):853–859. https://doi.org/10.1016/s0003-4975(03)00661-1 . (discussion 859–860) - DOI - PubMed
    1. Jones TK, McElhinney DB, Vincent JA, Hellenbrand WE, Cheatham JP, Berman DP, Zahn EM, Khan DM, Rhodes JF Jr, Weng S, Bergersen LJ (2022) Long-term outcomes after melody transcatheter pulmonary valve replacement in the US investigational device exemption trial. Circ Cardiovasc Interv 15(1):e010852. https://doi.org/10.1161/CIRCINTERVENTIONS.121.010852 - DOI - PubMed
    1. Abdullah I, Ramirez FB, McElhinney DB, Lock JE, del Nido PJ, Emani S (2012) Modification of a stented bovine jugular vein conduit (melody valve) for surgical mitral valve replacement. Ann Thorac Surg 94(4):e97–e98. https://doi.org/10.1016/j.athoracsur.2012.02.101 - DOI - PubMed
    1. Pluchinotta FR, Piekarski BL, Milani V, Kretschmar O, Burch PT, Hakami L, Meyer DB, Jacques F, Ghez O, Trezzi M, Carotti A, Qureshi SA, Michel-Behnke I, Hammel JM, Chai P, McMullan D, Mettler B, Ferrer Q, Carminati M, Emani SM (2018) Surgical atrioventricular valve replacement with melody valve in infants and children. Circ Cardiovasc Interv 11(11):e007145. https://doi.org/10.1161/CIRCINTERVENTIONS.118.007145 - DOI - PubMed

LinkOut - more resources