Key result
Prophylactic septal radiofrequency ablation successfully enlarged the left ventricular outflow tract area, permitting subsequent transcatheter mitral valve replacement.
Why the study?
Left ventricular outflow tract obstruction post valve deployment is a major limitation of transcatheter mitral valve replacement in high-surgical risk patients with severe mitral annular calcification.
Case Report (n=1)
Prophylactic septal radiofrequency ablation may be a feasible novel technique to prevent LVOT obstruction in patients undergoing TMVR when established septal reduction methods are ineffective or not feasible.
Hypothesis-generating for prophylactic septal ablation to facilitate TMVR; does not yet support routine clinical adoption.
Transcatheter mitral valve replacement (TMVR) with off-label use of aortic balloon-expandable transcatheter heart valves has emerged as a therapeutic option in high-surgical risk patients with severe mitral annular calcification. Left ventricular outflow tract (LVOT) obstruction post valve deployment is a major limitation. We describe a case of septal reduction therapy using radiofrequency ablation (RFA) when established methods of septal reduction were either ineffective or not feasible. RFA permitted successful enlargement of the LVOT area and subsequent TMVR.
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Killu et al. (2020) conducted a case report in Severe mitral annular calcification at high surgical risk (n=1). Prophylactic septal radiofrequency ablation (RADIO-TMVR) was evaluated on Enlargement of the LVOT area and subsequent TMVR. Prophylactic septal radiofrequency ablation successfully enlarged the left ventricular outflow tract area, permitting subsequent transcatheter mitral valve replacement.
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