Children undergoing heart valve replacement at Children's Mercy
now have a non-surgical option that is less invasive and gets them
home much sooner.
The Melody® transcatheter pulmonary valve therapy has been
authorized for use in pediatric and adult patients with a
regurgitant or stenotic Right Ventricular Outflow Tract (RVOT)
"The Melody valve allows us to replace a heart valve through a
catheter instead of open heart surgery," says Stephen Kaine, MD,
director of the Cardiovascular Laboratory at Children's Mercy,
Associate Director, The Ward Family Heart Center and an Associate
Professor of Pediatrics at the UMKC School of Medicine. "This is
specifically designed to replace a poorly functioning valve on the
right side of the heart. Some of the more common types of
congenital heart disease are conditions in which the pulmonary
valve is abnormal."
Until the use of the Melody valve by Children's Mercy
physicians, surgery was always required to put in a replacement
pulmonary valve. Unfortunately, the body sees a replacement as
foreign and attacks it. For very small babies, the valve will not
grow as the heart does. Both of these are reasons that more than
one intervention will likely be needed.
"The beauty of the Melody valve is that, instead of always
needing additional surgeries to replace the human valves over time,
we can use a stent on which a valve has been placed," says Dr.
Kaine. "Without doing open heart surgery, we can put the stent in
position and inflate it to place a functioning valve where it's
needed. Anytime you can avoid surgery safely, the patient comfort
and risk profiles are improved significantly."
This benefits patients by delaying the need for invasive surgery
for many years. In some cases, it may obviate the need for it
In addition, the time before discharge is reduced, which helps
both the patient and family. Instead of having to be hospitalized
for five to seven days, those who have treatment with the Melody
valve go home the next day. There are also obvious cost savings
achieved by earlier discharge.
"Like other replacement valves, the Melody will eventually wear
out," says Dr. Kaine. "What's been found is that a second Melody
valve can be placed if needed. It is not as though the valve
can be used only once and then you have to go back to surgical
The use of the Melody valve is a collaborative project between
Children's Mercy and the University of Kansas Medical Center.
"The number of centers in the United States working with the
Melody valves is still rather small," says Dr. Kaine.
"Collaboration between adult and pediatric services in Kansas City
means we should have one of the busier practices in the country.
Experience is critical for success in treating heart