Sequential Alcohol Septal Ablation to Resolve LV Outflow Tract Obstruction After Transcatheter Mitral Valve Replacement

Mark M P van den Dorpel; Mauricio Felippi de Sá Marchi; Sarah Verhemel; Rik Adrichem; Rutger-Jan Nuis; Joost Daemen; Marcel L Geleijnse; Claire Ben Ren; Alexander Hirsch; Nicolas M Van Mieghem

doi:10.1016/j.jaccas.2023.102193

Sequential Alcohol Septal Ablation to Resolve LV Outflow Tract Obstruction After Transcatheter Mitral Valve Replacement

JACC Case Rep. 2023 Dec 30;29(3):102193. doi: 10.1016/j.jaccas.2023.102193. eCollection 2024 Feb 7.

Affiliations

¹ Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
² Department of Cardiovascular Medicine, Heart Institute, Clinical Hospital, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
³ Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.

Abstract

Left ventricular outflow tract obstruction (LVOTO) is a notorious complication of transcatheter mitral valve replacement (TMVR). Computed tomography-derived simulations can predict neo-LVOTO post-TMVR, whereas alcohol septal ablation (ASA) can mitigate neo-LVOTO risk. We report a case of sequential ASA of 2 adjacent septal branches to resolve unexpected neo-LVOTO post-TMVR.

Keywords: alcohol septal ablation; left ventricular outflow tract obstruction; transcatheter mitral valve replacement.

Publication types

Case Reports