Melody Valve – The Nebraska Medical Center


I was born with tetralogy of fallot with pulmonary
atresia valve syndrome. When I was five I had my first procedure done. They put in a
pulmonary valve. And then when I was 15 they went in and replaced
that one. I’ve had that one up until now. ((sounds of procedure room)) The Melody Valve is a catheter-based implantable
valve that can replace a dysfunctional pulomnary valve. and it can be done by going through
the venous system through a skin-access point in the leg and avoid the patient having open
heart surgery to have valve replacement. So the first part of the case is always this
fairly involved diagnostic assessment of the outflow tract itself to make careful measurements
and know everything is the right size and know that we won’t be impacting things in
a bad way. Once that is done then we need to prepare
the landing area, landing zone for the new valve.
We need that to be uniform and round and of a length that is appropriate for the valve.
That’s done with a combination of high pressure angioplasty balloon and stenting to get that
to a uniform caliber of the right size and length for the valve.
And by doing that we protect the valve so that the valve itself doesn’t have to exert
that pressure to maintain the lenght and shape, it only has to open and close.
The other prep work we do creates a safe landing zone for it.
There are a series of washes we do because of the way the valve is treated to preserve
it for use. There are series of baths and washes we do. They are all timed and specific.
The valve, because it is sewn and prepared in the expanded shape, we have to manually
crimp it down onto the balloon catheter to give it the low profile to get in inside the
delivery system. so it needs to get down to a size of less
than 7mm. Which we just do by gradually lengthening
it and pushing it down so we get it on the balloon properly. And the final step, which is the most exciting
is putting the new valve, the stented valve in that prepared area and seeing that new
valve go up and immediately upon deflation of the balloon, the valve starts to move.
And restores full function of the valve which we test with pressure measurements and a final
picture that shows he has a competent valve in place and all the blood is going forward
only instead of forward and backward. It just felt like my heart was pumping so
much easier. You know I don’t know if it a lot of it was mental, but it was crazy – I
felt an immediate difference. It’s one of the most gratifying procedures
we do. To know that just a few years ago, these people would have had to have another
open heart surgery. And to be able to give them the exact same
valve product and see it work immediately and they wake up after the procedure and they’re
walking around the hallway that night and home the next day.
It’s just remarkable. It’s very fufilling. It’s just a crazy relief; not having to be
cut open again in my chest. I have a big 10 inch scar right here. Today
I’m leaving with a little, it’s about a centimeter in my thigh.
The last procedure I had at this time, I couldn’t even get out of bed. Now I’m leaving today
after just one day. It’s crazy how far it’s come in the last 12
years.

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