Lindsay R. Freud, MD, Gerald R. Marx, MD, Audrey C

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Assessment of the Melody valve in the mitral position in young children by echocardiography Lindsay R. Freud, MD, Gerald R. Marx, MD, Audrey C. Marshall, MD, Wayne Tworetzky, MD, Sitaram M. Emani, MD The Journal of Thoracic and Cardiovascular Surgery Volume 153, Issue 1, Pages 153-160.e1 (January 2017) DOI: 10.1016/j.jtcvs.2016.07.017 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Illustration of the actual (blue) and potential (red) mitral valve measurements in the (A) lateral and (B) anteroposterior dimensions at the level of the annulus. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 153-160.e1DOI: (10.1016/j.jtcvs.2016.07.017) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Correlation between the preoperative potential mitral valve (A) lateral and (B) anteroposterior dimensions and the maximum balloon dilation of the Melody valve intraoperatively. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 153-160.e1DOI: (10.1016/j.jtcvs.2016.07.017) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Examples of the Melody valve in the mitral position postoperatively by two-dimensional and color flow Doppler imaging in the (A, B) apical 4-chamber and (C, D) parasternal long-axis views. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 153-160.e1DOI: (10.1016/j.jtcvs.2016.07.017) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Examples of (A) left ventricular outflow tract obstruction as imaged from the parasternal long-axis view and (B) mild perivalvar leak as seen from the apical 4-chamber view. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 153-160.e1DOI: (10.1016/j.jtcvs.2016.07.017) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Bland–Altman plots demonstrating agreement between the (A) potential mitral valve lateral dimension and maximum balloon diameter and (B) potential mitral valve anteroposterior (AP) dimension and maximum balloon diameter. The x axis represents the average of each pair of measurements, and the y axis represents the difference between each pair. The solid line depicts the mean difference, and the dashed lines depict 2 standard deviations (SD) from the mean. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 153-160.e1DOI: (10.1016/j.jtcvs.2016.07.017) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Echocardiographic image of the Melody valve in the mitral position in a young child. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 153-160.e1DOI: (10.1016/j.jtcvs.2016.07.017) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Video 1 Intraoperative insertion of the modified Melody valve in the mitral position in a young patient. Video available at http://www.jtcvsonline.org/article/S0022-5223(16)30828-5/addons. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 153-160.e1DOI: (10.1016/j.jtcvs.2016.07.017) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Video 2 Transthoracic echocardiogram demonstrating a well-functioning Melody valve in the mitral position from an apical 4-chamber view. Video available at: http://www.jtcvsonline.org/article/S0022-5223(16)30828-5/addons. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 153-160.e1DOI: (10.1016/j.jtcvs.2016.07.017) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions