2017
DOI: 10.1002/ccd.27447
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Validating a prediction modeling tool for left ventricular outflow tract (LVOT) obstruction after transcatheter mitral valve replacement (TMVR)

Abstract: CAD design and CT postprocessing are indispensable tools in predicting LVOT obstruction and necessary for anatomic screening in percutaneous TMVR.

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Cited by 162 publications
(98 citation statements)
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“…Although less frequent with THVs dedicated to the mitral valve (< 1%), left ventricle outflow tract obstruction (LVOTO) has been reported in 1/8 patients when aortic THVs devices were used for TMVR [28][29][30]45]. LVOTO is defined by an increase of 10 mmHg or more of the transaortic gradient [46] and associated with higher mortality [43,[47][48][49]. New methods have been proposed as bailout procedures when operators confronted LVOTO.…”
Section: Transcatheter Mitral Valve Replacementmentioning
confidence: 99%
“…Although less frequent with THVs dedicated to the mitral valve (< 1%), left ventricle outflow tract obstruction (LVOTO) has been reported in 1/8 patients when aortic THVs devices were used for TMVR [28][29][30]45]. LVOTO is defined by an increase of 10 mmHg or more of the transaortic gradient [46] and associated with higher mortality [43,[47][48][49]. New methods have been proposed as bailout procedures when operators confronted LVOTO.…”
Section: Transcatheter Mitral Valve Replacementmentioning
confidence: 99%
“…We consider here that our simulations of these devicetissue interactions, using the described methodologies is a novel approach compared to currently employed expensive imaging modalities 2,3,4 . Current techniques used to predict LVOT obstruction require the use of CT imaging and computer-aided design (CAD) modeling 2,5 . The ongoing consensus within the dynamic transcatheter mitral valve replacement field is to best define the patient's VOT anatomy, such as the elongated LVOT post-implant as "neo-LVOT", and/or validate using multi-planar CT imaging.…”
Section: Discussionmentioning
confidence: 99%
“…Unfortunately, their insertion in the mitral position carries a significant risk of postprocedure LVOT obstruction. In one series, LVOT obstruction developed in 7 of 38 patients undergoing TMVR for a variety of indications . In another, 6 of 64 patients with severe MAC developed LVOT obstruction with significant mortality at 30 days …”
Section: Lvot Obstruction Following Transcatheter Mitral Valve Replacmentioning
confidence: 99%
“…A number of risk factors for neo‐LVOT obstruction have been identified including excessive incursion of the THV into the LV cavity, increased septal thickness, sigmoid septum, small LV cavity size, and acute aorto‐mitral angulation . In patients who have undergone TMVR for failed annuloplasty repair or severe MAC, an elongated and lax (myxomatous) native AML, which extends beyond the depth of the THV (Figure ), may increase the risk of neo‐LVOT obstruction.…”
Section: Lvot Obstruction Following Transcatheter Mitral Valve Replacmentioning
confidence: 99%
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