A major complication of transcatheter mitral valve replacement (TMVR) could be prevented using a newer percutaneous leaflet modification technique, according to registry data.
Early adopters of the so-called "BATMAN" (balloon-assisted translocation of the mitral anterior leaflet to prevent outflow tract obstruction) technique achieved successful TMVR without left ventricular outflow tract (LVOT) obstruction and procedural death in 95.1% of cases, reported Gennaro Giustino, MD, of Gagnon Cardiovascular Institute in Morristown, New Jersey.
The primary safety endpoint -- an in-hospital composite of death, stroke, or major cardiac structural complications -- occurred in 7.3% of patients, he noted at the EuroPCR meeting held annually in Paris.
"BATMAN was associated with high technical success, effectiveness in preventing LVOT obstruction, and appeared to be safe in ViR [valve-in-ring] and ViV [valve-in-valve] procedures," Giustino and co-authors wrote in JACC: Cardiovascular Interventions, where the study was published.
LVOT obstruction has long posed a major hurdle for the field of TMVR, a less invasive operation for patients with failed surgical valves, rings, or severe mitral annular calcification (MAC) not suitable for mitral valve surgery. Risk of LVOT obstruction is one reason for the notoriously high screen failure rates for TMVR candidates, hence the great interest in a dedicated device for leaflet laceration and valve technology that would allow broader anatomical suitability for patients.
