Melody Valve Implantation in Pulmonary Position

Surgical pulmonary valve replacement lacks longevity as conduit dysfunction usually occurs within 10–15 years and exposes patients to multiple risky operations over their lifetime. The recent availability of a percutaneous approach to treat RVOT dysfunction, therefore, offers an attractive solution, as it permits earlier intervention without the problems associated with surgery and cardiopulmonary bypass. Initial midterm results are promising, and the technique has proved safe and has provided efficacious relief of pressure and/or volume overload. These results are associated with improvement of symptoms and objective exercise capacity. However, PPVI is not free from possible complications. Due to anatomical (size and morphology) and dynamic reasons, with the current device, only 15 % of patients with RVOT dysfunction are eligible for such a treatment.