Antegrade Intentional Laceration of the Anterior Mitral Leaflet to Prevent Left Ventricular Outflow Tract Obstruction: A Simplified Technique From Bench to Bedside.

Circulation. Cardiovascular Interventions
John LiskoVasilis Babaliaros

Abstract

Intentional laceration of the anterior mitral leaflet (LAMPOON) is an effective adjunct to transcatheter mitral valve replacement that prevents left ventricular outflow tract (LVOT) obstruction. To date, LAMPOON has been performed in over 150 patients using a retrograde approach that can be technically challenging. A modified antegrade transseptal technique may simplify the procedure. Antegrade LAMPOON was developed and tested in nonsurvival pig experiments. Thereafter, antegrade LAMPOON was performed in patients at prohibitive risk of LVOT obstruction. Clinical, procedural, and angiographic details were abstracted from medical records of their index procedure, and were compared with findings in comparable patients at risk of fixed-LVOT obstruction in the LAMPOON investigational device exemption trial. Eight patients at risk of fixed LVOT obstruction underwent antegrade LAMPOON. Leaflet traversal and laceration were technically successful in all. There were no cases of clinically significant LVOT obstruction (mean LVOT gradient at discharge: 5.4±1.4 mm Hg). One patient suffered a ventricular wire perforation, unrelated to the antegrade LAMPOON technique, and did not survive to discharge. At the time of discharge, no patients ha...Continue Reading

References

May 5, 2017·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Adam B GreenbaumVasilis C Babaliaros
Apr 28, 2018·Journal of the American College of Cardiology·Mayra GuerreroTed Feldman
May 24, 2019·Journal of the American College of Cardiology·Jaffar M KhanRobert J Lederman

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Citations

Mar 6, 2021·JACC. Cardiovascular Interventions·John C LiskoAdam B Greenbaum
Mar 6, 2021·JACC. Cardiovascular Interventions·Mohamed Abdel-Wahab, David Holzhey
Oct 13, 2021·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Itsik Ben-DorToby Rogers
Nov 30, 2021·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Matheus SimonatoDanny Dvir

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