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Neo-LVOT and Transcatheter Mitral Valve Replacement
Anna Reid ,
Sagit Ben Zekry ,
Mansi Turaga ,
Stephanie Tarazi ,
Jeroen J. Bax ,
Dee Dee Wang ,
Nicolo Piazza ,
Vinayak N. Bapat ,
Abdul Rahman Ihdayhid ,
João L. Cavalcante ,
Philipp Blanke ,
Jonathon Leipsic
April 2021
April 2021
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Abstract
<p class="first" id="d2798566e190">With the advent of transcatheter mitral valve replacement
(TMVR), the concept of the
neo-left ventricular outflow tract (LVOT) was introduced and remains an essential
component of treatment planning. This paper describes the LVOT anatomy and provides
a step-by-step computed tomography methodology to segment and measure the neo-LVOT
while discussing the current evidence and outstanding challenges. It also discusses
the technical and hemodynamic factors that play a major role in assessing the neo-LVOT.
A summary of expert-based recommendations about the overall risk of LVOT obstruction
in different scenarios is presented along with the currently available methods to
reduce the risk of LVOT obstruction and other post-procedural complications.
</p>