How Would We Treat Our Own Left Ventricular Outflow Tract Obstruction in Transcatheter Mitral Valve Replacement?

Jacopo D'Andria Ursoleo; Viviana Teresa Agosta; Alice Bottussi; Filippo D'Amico; Fabrizio Monaco

doi:10.1053/j.jvca.2025.02.019

How Would We Treat Our Own Left Ventricular Outflow Tract Obstruction in Transcatheter Mitral Valve Replacement?

J Cardiothorac Vasc Anesth. 2025 Feb 18:S1053-0770(25)00140-5. doi: 10.1053/j.jvca.2025.02.019. Online ahead of print.

Authors

Jacopo D'Andria Ursoleo¹, Viviana Teresa Agosta¹, Alice Bottussi¹, Filippo D'Amico¹, Fabrizio Monaco²

Affiliations

¹ Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
² Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy. Electronic address: monaco.fabrizio@hsr.it.

PMID: 40074585
DOI: 10.1053/j.jvca.2025.02.019

Abstract

This article aims to provide a comprehensive review of the current knowledge on the prevention and treatment of left ventricular outflow tract obstruction (LVOTO) associated with transcatheter mitral valve replacement-a novel and evolving treatment alternative for mitral regurgitation-encompassing both surgical and pharmacological interventions. LVOTO is a potentially catastrophic complication of transcatheter mitral valve replacement. Therefore, identifying patients at high risk for LVOTO and implementing a carefully tailored medical and surgical strategy are essential for optimizing perioperative management and improving patient outcomes.

Keywords: hemodynamics; left ventricular outflow tract obstruction; mitral regurgitation; transcatheter mitral valve replacement.