{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T18:08:29Z","timestamp":1772993309272,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,11,20]],"date-time":"2018-11-20T00:00:00Z","timestamp":1542672000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study reports long\u2010term outcomes percutaneous Melody valve (Medtronic, Minneapolis, Minnesota) valve\u2010in\u2010valve therapy in patients with prosthetic valve dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Repeat valve surgery is associated with high morbidity and mortality. Transcatheter mitral valve\u2010in\u2010valve is a promising alternative in patients at high\u2010risk for cardiac surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective cohort analysis of 13 patients who underwent Melody valve\u2010in\u2010valve for bioprosthetic dysfunction from July 2011 to October 2013.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean age was 74.4 years, 46% male, and STS score 13.5\u2009\u00b1\u20096.8%. All patients had NYHA class 3 or 4 symptoms with improvement to class 1 or 2 in 82% post procedure. Median follow\u2010up was 4.5 years with longest follow\u2010up of 5.5 years. Thirty\u2010day mortality was 15.4% with 1\u2010year mortality of 25% and no other reported deaths until 4.5 years. 76.9% of patients had mitral gradient of 5 mmHg or less immediately postprocedure. One patient required repeat valve procedure for structural deterioration at 4.4 years. At 1, 3, and 5 year follow\u2010ups 75% of patients were NYHA class 1 or 2, mean gradients were 4.5\u2009\u00b1\u20090.6, 6.8\u2009\u00b1\u20090.5, and 7.5\u2009\u00b1\u20090.7, respectively. Using 4\u2010point scale, mitral regurgitation postprocedure was 0.8\u2009\u00b1\u20090.6. At 1, 3, and 5 years this increased to 1.0\u2009\u00b1\u20091.1, 1.3\u2009\u00b1\u20091.3, and 2.5\u2009\u00b1\u20092.1, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Melody valve\u2010in\u2010valve therapy was effective with 1\u2010year symptomatic improvement. Prosthesis deterioration requiring repeat intervention was observed in one patient. Larger cohorts with multicenter registries are needed to determine the role of this percutaneous valve\u2010in\u2010valve therapy as valve technology and procedural techniques improve.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.27988","type":"journal-article","created":{"date-parts":[[2018,11,21]],"date-time":"2018-11-21T08:52:45Z","timestamp":1542790365000},"page":"1087-1094","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Long\u2010term outcomes of melody valve\u2010in\u2010valve implantation for bioprosthetic mitral valve dysfunction"],"prefix":"10.1002","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5109-1198","authenticated-orcid":false,"given":"Timothy A.","family":"Joseph","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Diseases Mayo Clinic  Rochester 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