Tuesday, June 21, 2011

Cath: Melody Valve in Contegra Graft - Animal Study

Circulation. 2010;122:A19333


Abstract 19333: Transcatheter Delivery of Melody Valves (MelV) Larger Than Contegra Conduit (CC)


Core 3. Genetics, Genomics and Congenital CV Disorders

Session Title: Cardiac Catheterization and Electrophysiology in the Young

Prakul Chanthong; Luis Quinonez; Patty Boylen; Jon Timinsky; James Y Coe

UNIVERSITY ALBERTA HOSPITAL, Edmonton, Canada; Medtronic Canada, Missisauga, Canada; UNIVERSITY ALBERTA HOSPITAL, Edmonton, Canada

Transcatheter replacement of pulmonary valves is used in failed right ventricular to pulmonary artery (RV-PA) homografts (H) or prosthetic valves (PV). The former calcify and the latter have metal rings ± struts, both providing secure landing spots for MelV. The MelV expansion is limited by the H or PV size, and H may rupture if expanded beyond its original diameter. CCs often do not calcify, yet may become aneurysmal with increased intraluminal pressure. We tested the hypothesis that transcatheter MelV replacement is possible in a hypertensive, supported CC. Under general anesthesia, supported 18 mm CCs were placed as descending aortic jump grafts via a left thoracotomy in sheep (n=6). After a recovery period, 22 mm MelVs (n=4) were delivered via a carotid artery into the CCs. 56-82 (mean 72) days after aortic placement, the 18 mm CC dilated to 36-37 mm under systemic pressure, while the ring diameter remained at 18 mm. Deploying the MelV at 22 mm expanded the CC rings to 22 mm. without CC rupture. Transcatheter Melody valve replacement into the Contegra conduits is feasible. The Melody valve will expand the rings of the Contegra conduit to the largest valve diameter.

Formula

Author Disclosures: P. Chanthong, None; L. Quinonez, None; P. Boylen, Medtronic, Modest, Employment; J. Timinsky, None; J.Y. Coe, Medtronic, Modest, Consultant/Advisory Board; NuMed, Modest,Consultant/Advisory Board.

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