Key result
Echo-guided ASA, LAMPOON, and BATMAN prevent LVOTO and improve mitral function during ViV TMVR.
Why the study?
LVOT obstruction after ViV TMVR carries high mortality, and echocardiographic presentation during preventative procedures like LAMPOON and BATMAN may be unfamiliar to clinicians.
Does echocardiography-guided ASA, LAMPOON, and BATMAN prevent LVOTO during ViV TMVR?
Case Report (n=1)
Does echocardiography-guided ASA, LAMPOON, and BATMAN prevent LVOTO during ViV TMVR?
Echocardiography plays an essential role in guiding advanced interventional techniques like ASA, LAMPOON, and BATMAN to prevent LVOTO during high-risk ViV TMVR.
Should not yet change LVOTO-prevention strategy in ViV TMVR; leaves open combined LAMPOON-BATMAN pending larger series.
Left ventricular outflow tract (LVOT) obstruction (LVOTO) after transcatheter mitral valve replacement (TMVR) continues to be a major concern and carries a high risk of mortality. Patients undergoing valve-in-valve (ViV) procedures are at increased risk of LVOTO with hemodynamic compromise. The combination of laceration of the anterior mitral leaflet to prevent outflow obstruction (LAMPOON) and balloon-assisted translocation of the mitral anterior leaflet (BATMAN) procedures to prevent LVOTO has proven to be successful. However, the presentation on echocardiography during TMVR implantation and surveillance imaging may be complicated or unfamiliar to those with limited structural heart imaging experience. This case study provides a successful two-phase intervention for ViV TMVR utilizing echocardiography during alcohol septal ablation, LAMPOON, and BATMAN procedures. In addition, it describes the ViV implantation posttreatment results demonstrating improved mitral valvular function and successful prevention of LVOTO. These diagnostic findings highlight the essential role of echocardiography in treating high-risk patients and underscore the value of these advanced interventional techniques.
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Joleen D. Rodriguez (2026) conducted a case report in High risk of left ventricular outflow tract obstruction during transcatheter mitral valve replacement (n=1). Echocardiography-guided alcohol septal ablation, LAMPOON, and BATMAN procedures was evaluated on Prevention of LVOTO and improved mitral valvular function. Echocardiography-guided alcohol septal ablation, LAMPOON, and BATMAN procedures successfully prevented left ventricular outflow tract obstruction and improved mitral valvular function during ViV TMVR.
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