LAUSR

Congenital mitral valve disease is an uncommon condition. Medical treatment can be very complicated in some cases, leaving surgery as the only option. Surgical valvuloplasty often fails in children, especially in neonates and young infants, due to the presence of dysplastic valves with a small annulus and special anatomic features. In such cases, valve replacement is generally the only solution. We present 3 cases of Melody valve implantation in the mitral position. Patient 1 was a 4-month-old infant weighing 4.6 kg with severe mitral regurgitation (MR) (valve with thickened leaflets, reduced mobility, and absence of central coaptation; annulus of 15 mm) that was refractory to medical treatment. Following Kay-Wooler annuloplasty, the boy showed moderate residual MR and was extubated, but he developed severe MR 14 days later and required ventilatory support. We decided to implant a Melody valve in the mitral position using the Boston technique with some modifications. Before initiation of extracorporeal circulation, the valve was expanded to 18 mm and a 3-mm pericardial sewing cuff was added