Neo-LVOT and Transcatheter Mitral Valve Replacement Expert Recommendations

被引:60
作者
Reid, Anna [1 ]
Ben Zekry, Sagit [1 ]
Turaga, Mansi [1 ]
Tarazi, Stephanie [1 ]
Bax, Jeroen J. [2 ]
Wang, Dee Dee [3 ]
Piazza, Nicolo [4 ]
Bapat, Vinayak N. [5 ]
Ihdayhid, Abdul Rahman [1 ]
Cavalcante, Joao L. [6 ]
Blanke, Philipp [1 ]
Leipsic, Jonathon [1 ]
机构
[1] Univ British Columbia, St Pauls Hosp, Ctr Heart Lung Innovat, Vancouver, BC, Canada
[2] Leiden Univ, Med Ctr, Dept Cardiol, Leiden, Netherlands
[3] Henry Ford Hlth Syst, Ctr Struct Heart Dis, Detroit, MI USA
[4] McGill Univ, Ctr Hlth, Div Cardiol, Dept Med, Montreal, PQ, Canada
[5] Columbia Univ, Irving Med Ctr, NewYork Presbyterian, Dept Med, New York, NY USA
[6] Abbott NW Hosp, Minneapolis Heart Inst, Minneapolis, MN USA
关键词
LVOT; LVOT obstruction; neo-LVOT; transcatheter mitral valve replacement; OUTFLOW TRACT OBSTRUCTION; SEPTAL ABLATION; IN-VALVE; IMPLANTATION; OUTCOMES; REGURGITATION; ANNULOPLASTY; MANAGEMENT; CONSENSUS; FAILURE;
D O I
10.1016/j.jcmg.2020.09.027
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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. (C) 2021 by the American College of Cardiology Foundation.
引用
收藏
页码:843 / 866
页数:13
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