Placement of Covered Stent followed by Melody Valve

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Placement of Covered Stent followed by Melody Valve

By Pediatric and Adult Interventional Cardiac Symposium FEATURING Makram Ebeid

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March 14, 2014

History:

• 18 year old, Truncusarteriosus s/p surgery as an infant in a different state ...
read more ↘ using 12 mm conduit. In 1999 underwent replacement of the RV to PA conduit using pulmonary homograft. Operative note could not be located.

Physical Findings:

• General: Delayed, suggestive of Di George syndrome

• wt. 61 kg, Ht 160 cm BP 113/71

• Chest CTA,

• Active precordium with RV lift

• 3/6 Harsh ejection systolic murmur heard along the entire precordium

• 2/6 early diastolic murmur at the left sternal border

• Liver palpable at the right coastal margin

• He and his grandmother do not want surgery

Pertinent Tests:

EKG:

• NSR, RBBB

Echo:

• Mild truncal valve regurge and mild truncal valve stenosis

• Severe PI; Severe PS (peak Gradient 97 mmhg, mean gradient 61 mmhg)

CT/MR:

• RV volume 74 ml/M2 with moderate RVH, dilated RA

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