Prevention of LVOT Obstruction by Device-Mediated Laceration of the Anterior Mitral Valve Leaflet During TMVR.

Left ventricular outflow tract obstruction represents a life-threatening complication in patients undergoing transcatheter mitral valve replacement. Interventional approaches to prevent left ventricular outflow tract obstruction are complex and require exceptional procedural expertise. We demonstrate feasibility and safety of first-in-human device-mediated mechanical laceration of the anterior mitral valve leaflet prior to transapical transcatheter mitral valve replacement. (

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© 2023 The Authors.

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This study was supported by a personal grant from the German Heart Foundation to Dr Ludwig. A professional medical illustrator was paid by Pi-Cardia and provided Figures 3, 4, and 6. Dr Ludwig has received travel compensation from Edwards Lifesciences; has received advisory fees from Bayer; and has received speaker honoraria from Abbott. Dr Kalbacher has received personal fees from Edwards Lifesciences, Abbott Medical, and Pi-Cardia. Dr Schaefer has received speaker honoraria from Abbott. Dr Denti has received speaker honoraria from Abbott and Edwards Lifesciences; and is a consultant for Pi-Cardia, InnovHeart HRV, and Approxima. Dr Schofer has received speaking honoraria and proctor fees from Edwards Lifesciences. Dr Conradi is an advisory board member for Abbott, Medtronic, JenaValve, and MicroPort; and has received personal fees from Edwards Lifesciences, Boston Scientific, Neovasc, Highlife, Pi-Cardia, and MicroInterventions. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.