McGowan Institute for Regenerative Medicine
affiliated faculty member Jacqueline Kreutzer, MD (pictured), Director of the Cardiac Catheterization Laboratory at Children's Hospital of Pittsburgh and also an Assistant Professor in Pediatrics in the Department of Pediatrics at the University of Pittsburgh School of Medicine, recently performed a heart valve replacement procedure using the Medtronic Melody Transcatheter Pulmonary Valve (pictured) and Ensemble Delivery System. Children's Hospital of Pittsburgh became the first U.S. site outside of the clinical study to do a valve replacement procedure using this new system. With the Medtronic Melody Valve Therapy, congenital heart disease patients with failed pulmonary conduits now have a treatment option designed to restore pulmonary valve function while delaying the need for open-heart surgery.
The most common congenital heart defects affecting the pulmonary valve include:
- Pulmonary atresia
- Great transposition of the arteries
- Tetralogy of Fallot
- Double outlet right ventricle
Children or adults with these conditions have narrowed or missing pulmonary valves and need surgery for placement of a right ventricular outflow tract (RVOT) or pulmonary conduit. A pulmonary conduit is a tube that opens up the RVOT and contains an artificial valve to control blood flow between the right ventricle and the pulmonary artery. Pulmonary valve conduit failure occurs when an artificial pulmonary valve conduit stops working the way it should, preventing adequate blood flow from the heart to the lungs.
Transcatheter pulmonary valve therapy is an alternative to surgery for children and adults with pulmonary valve conduit failure. It does not replace open-heart surgery as a treatment for conduit failure, however it is intended to delay the need for surgical intervention. The Melody Transcatheter Pulmonary Valve is a heart valve attached to a stent (wire frame) that functions as an artificial pulmonary valve for patients with failed pulmonary valve conduits.
During Dr. Kreutzer’s recent procedure with the transcatheter pulmonary valve therapy, a catheter (a thin, hollow tube) holding an artificial heart valve was inserted into a vein in her patient’s leg and guided up to his heart. The heart valve was attached to a wire frame that expanded with the help of balloons to deliver the valve. Once the new heart valve was in position, it began to work immediately. The benefits include the fact that the patient’s chest wasn’t opened and the heart was not stopped. The procedure took between 1 to 2 hours.
Dr. Kreutzer anticipates doing more procedures in the future. "We do have several candidates that will be evaluated," she said.
Illustrations: Dr. Kreutzer, McGowan Institute for Regenerative Medicine. The Melody Transcatheter Pulmonary Valve, Medtronic.
Pittsburgh Post-Gazette (03/31/10)
Medtronic: About Transcatheter Pulmonary Valve Therapy