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LAMPOON techniques to prevent or manage left ventricular outflow tract obstruction in transcatheter mitral valve replacement. 2021

Brian C Case, and John C Lisko, and Vasilis C Babaliaros, and Adam B Greenbaum, and Lowell Satler, and Itsik Ben-Dor, and Brian J Forrestal, and Charan Yerasi, and Norihiko Kamioka, and Toby Rogers, and Ron Waksman, and Robert J Lederman, and Jaffar M Khan
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA.

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.

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