Year : 2021 | Volume
: 14 | Issue : 2 | Page : 249-
Mitral valve replacement in infants
Department of Cardiothoracic Surgery, AIIMS, New Delhi; Senior Consultant, Max Super Specialty Hospital, Ghaziabad, Uttar Pradesh, India
Department of Cardiothoracic Surgery, AIIMS, New Delhi; Senior Consultant, Max Super Specialty Hospital, Ghaziabad, Uttar Pradesh
|How to cite this article:|
Sampathkumar A. Mitral valve replacement in infants.Ann Pediatr Card 2021;14:249-249
|How to cite this URL:|
Sampathkumar A. Mitral valve replacement in infants. Ann Pediatr Card [serial online] 2021 [cited 2022 May 23 ];14:249-249
Available from: https://www.annalspc.com/text.asp?2021/14/2/249/315283
I read with interest the article by Dranseika et al. on Melody valve for mitral valve replacement (MVR) in small children. Although the numbers are small, their efforts are to be applauded for attempting to overcome the difficulties of MVR in small children. They conclude that it is FEASIBLE and reproducible. They also conclude that this offers a better solution to EXISTING alternatives for infants requiring prosthetic mitral valve.
Feasibility alone should not be a deciding factor as it is dependent on the surgeon's skill and availability of alternatives. It is surprising that they have not considered all the existing alternatives available for such a situation. The pulmonary autograft is an excellent substitute and provides a far superior option., It is a living valve, does not degenerate, and allows growth of the valve. In the reconstruction of the right ventricular outflow tract, they could use a homograft, Contegra valve, or the Melody valve with the option of balloon dilatation if required. This is a superior option to using the Melody valve in the mitral position. Presumably, the European tissue banks would have adequate supply of homografts.
Another option is to use a pediatric heart-transplant recipient's aortic or pulmonary valve (homovital valve) as a replacement for the mitral valve in infants in the Ross II technique., This will be similar to the Ross II operation and technically simpler option to safeguard and retain the pulmonary autograft for any later requirement.
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Conflicts of interest
There are no conflicts of interest.
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