Prevention of LVOT Obstruction by Device-Mediated Laceration of the Anterior Mitral Valve Leaflet During TMVR

Sebastian Ludwig; Daniel Kalbacher; Lara Waldschmidt; Andreas Schaefer; Thomas Modine; Danny Dvir; Shemy Carasso; Paolo Denti; Niklas Schofer; Lenard Conradi

doi:10.1016/j.jaccas.2023.101873

Prevention of LVOT Obstruction by Device-Mediated Laceration of the Anterior Mitral Valve Leaflet During TMVR

JACC Case Rep. 2023 May 11:16:101873. doi: 10.1016/j.jaccas.2023.101873. eCollection 2023 Jun 21.

Authors

Sebastian Ludwig^{1

2

3}, Daniel Kalbacher^{1

2}, Lara Waldschmidt^{1

2}, Andreas Schaefer^{2

4}, Thomas Modine⁵, Danny Dvir⁶, Shemy Carasso⁶, Paolo Denti⁷, Niklas Schofer^{1

2}, Lenard Conradi^{2

4}

Affiliations

¹ Department of Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Germany.
² German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany.
³ Cardiovascular Research Foundation, New York, New York, USA.
⁴ Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Hamburg, Germany.
⁵ Unité Médico Chirurgicale de Valvulopathie, CHU de Bordeaux, Bordeaux, France.
⁶ Department of Cardiology, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
⁷ Department of Cardiac Surgery, Ospedale San Raffaele, Milan, Italy.

Abstract

Left ventricular outflow tract obstruction represents a life-threatening complication in patients undergoing transcatheter mitral valve replacement. Interventional approaches to prevent left ventricular outflow tract obstruction are complex and require exceptional procedural expertise. We demonstrate feasibility and safety of first-in-human device-mediated mechanical laceration of the anterior mitral valve leaflet prior to transapical transcatheter mitral valve replacement. (Level of Difficulty: Advanced.).

Keywords: LVOT obstruction; leaflet laceration; transcatheter mitral valve replacement.

Publication types

Case Reports