P. Padovani , V. Fouilloux , J.B. Thambo , M. Ly , P. Aldebert , O. Baron , F. Roubertie , N. Benbrik , C. Ovaert , Z. Jalal , A.E. Baruteau
{"title":"Risk of infective endocarditis after hybrid Melody mitral valve replacement in infants: The French experience","authors":"P. Padovani , V. Fouilloux , J.B. Thambo , M. Ly , P. Aldebert , O. Baron , F. Roubertie , N. Benbrik , C. Ovaert , Z. Jalal , A.E. Baruteau","doi":"10.1016/j.acvdsp.2023.07.021","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Surgical management of mitral valve (MV) disease is challenging in infants. We aimed at reporting the French experience with Melody mitral valve replacement (MVR).</p></div><div><h3>Methods</h3><p><span>A retrospective cohort study reporting the French experience with Melody </span>MV replacement (MVR).</p></div><div><h3>Results</h3><p><span>Seven symptomatic infants (complete atrioventricular septal defect [</span><em>n</em> <!-->=<!--> <!-->4, down syndrome: <em>n</em> <!-->=<!--> <!-->3], hammock MV [<em>n</em> <!-->=<!--> <!-->3]) underwent Melody MVR (age: 3 months [28 days–8 months], weight: 4.3<!--> <!-->kg [3.2–6.4<!--> <span>kg]) because of severe MV regurgitation (6) or mixed MV disease (1) and 14</span> <!-->mm (11–16<!--> <span>mm) MV annulus. In 2 patients whose MV was felt irreparable, Melody MVR was performed straightaway. The others underwent 2 (1–3) previous attempts of MV repair; 3 were on ECMO. Melody MVR led to competent valve and low gradient (3</span> <!-->mmHg, [1–4<!--> <!-->mmHg]). One patient died 3 days post-implant from ECMO-related stroke. Of the 6 discharged home patients, 3 (50%) were readmitted for a definite diagnosis (1) or high suspicion (2) of infective endocarditis, of which 2 died. Over the follow-up, one underwent balloon expansions of the valve at 9- and 16-months post-implant, and mechanical MVR at 2 years; another is currently planned for transcatheter Melody valve dilation.</p></div><div><h3>Conclusion</h3><p>Melody MVR may be considered in selected infants with small MV annulus as an alternative to mechanical MVR. Our experience highlights a high-risk of late IE that deserves further consideration.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":null,"pages":null},"PeriodicalIF":18.0000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Cardiovascular Diseases Supplements","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1878648023002422","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Surgical management of mitral valve (MV) disease is challenging in infants. We aimed at reporting the French experience with Melody mitral valve replacement (MVR).
Methods
A retrospective cohort study reporting the French experience with Melody MV replacement (MVR).
Results
Seven symptomatic infants (complete atrioventricular septal defect [n = 4, down syndrome: n = 3], hammock MV [n = 3]) underwent Melody MVR (age: 3 months [28 days–8 months], weight: 4.3 kg [3.2–6.4 kg]) because of severe MV regurgitation (6) or mixed MV disease (1) and 14 mm (11–16 mm) MV annulus. In 2 patients whose MV was felt irreparable, Melody MVR was performed straightaway. The others underwent 2 (1–3) previous attempts of MV repair; 3 were on ECMO. Melody MVR led to competent valve and low gradient (3 mmHg, [1–4 mmHg]). One patient died 3 days post-implant from ECMO-related stroke. Of the 6 discharged home patients, 3 (50%) were readmitted for a definite diagnosis (1) or high suspicion (2) of infective endocarditis, of which 2 died. Over the follow-up, one underwent balloon expansions of the valve at 9- and 16-months post-implant, and mechanical MVR at 2 years; another is currently planned for transcatheter Melody valve dilation.
Conclusion
Melody MVR may be considered in selected infants with small MV annulus as an alternative to mechanical MVR. Our experience highlights a high-risk of late IE that deserves further consideration.
期刊介绍:
Archives of Cardiovascular Diseases Supplements is the official journal of the French Society of Cardiology. The journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles, editorials, and Images in cardiovascular medicine. The topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Additionally, Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.