Nonsurgical Heart Valve Replacement Showing Positive Outcomes 

More children with congenital heart valve defects are avoiding open-heart surgery and long hospital stays thanks to a less-invasive corrective procedure offered at Valley Children’s.

In 2013, Valley Children’s was the first hospital in the region to perform a nonsurgical heart valve replacement using the Melody Transcatheter Pulmonary Valve.

Dr. Carl Owada, medical director of the pediatric cardiac catheterization laboratory, and Dr. Paolo Aquino, a pediatric cardiologist and specialist in interventional cardiac catheterization, perform the procedure. So far, nine patients have received Melody valve implantations.

The nonsurgical procedure allows patients to avoid the longer recovery times associated with open-heart surgery, and perhaps decrease the number of surgeries needed over time. Dr. Aquino, who led the medical team that implanted the first device in 2013, said each of Valley Children’s nine patients has responded well.

“Hopefully, we will perform more of the procedures as we continue to have good outcomes,” he said. The Hospital’s Willson Heart Center is monitoring about 150 children who have had valve replacements and may be future candidates.

Congenital heart defects are the most common form of major birth defect. In some cases, babies are born with a defective pulmonary valve – the mechanism that opens to allow blood to flow from the heart to the lungs to receive oxygen.

Many patients require surgery to implant a conduit or tube to assure the blood flow. However, those conduits don’t grow and can become leaky or narrowed over time – which often means they must be replaced.

“In the past, the method of fixing these conduits was to replace them – take out the old one, put in a new one, and that would be done surgically,” Dr. Aquino said.

Approved in 2010 by the U.S. Food and Drug Administration, the Melody valve is an alternative and minimally invasive procedure. The artificial valve is sewn into a wire stent and compressed onto a balloon on the tip of a catheter, a long and hollow tube. The catheter is inserted into a vein – most often in the leg – and then pushed into place in the heart. The balloon is inflated to deploy the valve and the catheter is then removed.

Generally, a patient undergoing the procedure remains in the hospital overnight and goes home the next day. A patient who has open-heart surgery likely would stay in the hospital for about a week.

Doctors must evaluate patients to determine their suitability for the Melody valve. For example, an implanted conduit may be too small for the valve.

Families with children who have had the procedure at Valley Children’s have been pleased to avoid the pain and lengthy recovery typically associated with surgery.

“Parents and children have been very receptive because of the benefits,” Dr. Aquino said. “Patients spend less time in the hospital and can continue on with the rest of their lives.”