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Left Ventricular Outflow Tract Obstruction After Transcatheter Mitral Valve-in-Ring Implantation: A Word of Caution  Sameh M. Said, MD, Sorin Pislaru,

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Presentation on theme: "Left Ventricular Outflow Tract Obstruction After Transcatheter Mitral Valve-in-Ring Implantation: A Word of Caution  Sameh M. Said, MD, Sorin Pislaru,"— Presentation transcript:

1 Left Ventricular Outflow Tract Obstruction After Transcatheter Mitral Valve-in-Ring Implantation: A Word of Caution  Sameh M. Said, MD, Sorin Pislaru, MD, Kunal D. Kotkar, MD, Charanjit S. Rihal, MD, William J. Mauermann, MD, Hartzell V. Schaff, MD, Joseph A. Dearani, MD  The Annals of Thoracic Surgery  Volume 102, Issue 6, Pages e495-e497 (December 2016) DOI: /j.athoracsur Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Transesophageal echocardiographic view with long axis of the left ventricular outflow tract during systole. The anterior mitral leaflet is pushed anteriorly by the mitral prosthesis stent, resulting in pronounced systolic anterior motion and severe dynamic obstruction of the left ventricular outflow. The Annals of Thoracic Surgery  , e495-e497DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 (A) Intraoperative view showing the anterior mitral valve leaflet (AML) projecting in the left ventricular outflow tract (LVOT) (*) seen through both aortic prostheses. (B) Intraoperative view showing severe LVOT obstruction resulting from the displaced AML. The interventricular septum (septum) is visible. (Ao = aorta.) The Annals of Thoracic Surgery  , e495-e497DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 (A) Intraoperative view looking through the aortic prostheses. The anterior mitral leaflet (AML) being excised with the mitral Sapien S3 valve (arrow) appears deep in the left ventricular outflow tract (LVOT). (1 = Mitroflow prosthesis; 2 = Sapien XT valve; Ao = aorta.) (B) Closer view of the AML during excision through the Sapien XT aortic prosthesis, and the Sapien S3 valve in the mitral position appears projecting in the LVOT. (C) Intraoperative view looking through the aortic prostheses showing the widely opened LVOT after complete excision of the AML. (IVS = interventricular septum.) (D) Transesophageal echocardiographic view after surgical resection of the AML. Note laminar flow in the LVOT. (Ao = aorta.) The Annals of Thoracic Surgery  , e495-e497DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

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