LAMPOON techniques to prevent or manage left ventricular outflow tract obstruction in transcatheter mitral valve replacement

• Type of Material: Article
• Authors: Brian C. Case, MedStar Washington Hospital Center; John C. Lisko, Emory University Hospital; Vasilis Babaliaros, Emory University; Adam Greenbaum, Emory University; Lowell Satler, MedStar Washington Hospital Center; Itsik Ben-Dor, MedStar Washington Hospital Center; Brian J. Forrestal, MedStar Washington Hospital Center; Charan Yerasi, MedStar Washington Hospital Center; Norihiko Kamioka, Emory University Hospital; Toby Rogers, MedStar Washington Hospital Center; Ron Waksman, MedStar Washington Hospital Center; Robert Lederman, Emory University; Jaffar M. Khan, National Heart, Lung and Blood Institute
• Language: English
• Date: 2021-01-01
• Publisher: AME PUBL CO
• Publication Version: Final Published Version
• Copyright Statement: 2021 Annals of Cardiothoracic Surgery.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.21037/acs-2020-mv-25
• Title of Journal or Parent Work: ANNALS OF CARDIOTHORACIC SURGERY
• Volume: 10
• Issue: 1
• Start Page: 172
• End Page: 179
• Grant/Funding Information: Supported by the Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, USA (Z01-HL006040).
• Keywords: Science & Technology; Cardiac & Cardiovascular Systems; Cardiovascular System & Cardiology; tip-to-base LAMPOON; LACERATION; antegrade LAMPOON; Life Sciences & Biomedicine; left ventricular outflow tract obstruction (LVOT obstruction); REGURGITATION; Transcatheter mitral valve replacement (TMVR); LAMPOON; OUTCOMES; Surgery; LEAFLET
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Transcatheter mitral valve replacement (TMVR) is a therapeutic option for patients with severe mitral disease who are deemed inoperable due to their overall surgical risk. The close relationships between the left ventricular outflow tract (LVOT) and the anterior mitral valve leaflet can lead to LVOT obstruction, a common complication with high mortality. Predicting and preventing LVOT obstruction is therefore essential, prior to TMVR. Laceration of the Anterior Mitral leaflet to Prevent Outflow ObtructioN (LAMPOON) is a transcatheter electrosurgical technique to split the anterior mitral valve leaflet immediately prior to TMVR. The technique has been studied in a prospective clinical trial and has evolved with many iterations for specific anatomies. In this review, we discuss the different LAMPOON techniques to prevent and treat LVOT obstruction.