Mitral Regurgitation and Left Ventricular Outflow Tract Obstruction: Confluence of Challenges for Transcatheter Treatment

Antonio Sisinni; Manuel Barreiro-Pérez; Francisco Calvo-Iglesias; Rodrigo Estévez-Loureiro

doi:10.31083/j.rcm2504134

Mitral Regurgitation and Left Ventricular Outflow Tract Obstruction: Confluence of Challenges for Transcatheter Treatment

Rev Cardiovasc Med. 2024 Apr 3;25(4):134. doi: 10.31083/j.rcm2504134. eCollection 2024 Apr.

Authors

Antonio Sisinni¹, Manuel Barreiro-Pérez^{1

2}, Francisco Calvo-Iglesias^{1

2}, Rodrigo Estévez-Loureiro^{1

2}

Affiliations

¹ Department of Cardiology, University Hospital Alvaro Cunqueiro, 36312 Vigo, Spain.
² Cardiovascular Research Group, Department of Cardiology, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute (IIS Galicia Sur), Servizo Galego de Saude, University of Vigo, 36312 Vigo, Spain.

Abstract

The intricate interplay between mitral regurgitation (MR) and left ventricular outflow tract (LVOT) obstruction may result in two clinical scenarios: prosthesis-related LVOT obstruction after mitral valve replacement (TMVR) and systolic anterior motion (SAM)-associated MR. This review provides a comprehensive overview of the pathophysiology, risk assessment, and transcatheter interventions for mitigating the likelihood of LVOT obstruction in patients undergoing TMVR. In addition, it extends its focus to SAM-associated MR, elucidating the different aetiological mechanisms contributing to this phenomenon, beyond hypertrophic cardiomyopathy. Transcatheter treatment options, are explored as potential therapeutic strategies, offering insights into their hemodynamic effectiveness and limitations.

Keywords: left ventricular outflow tract obstruction; management; mitral regurgitation; transcatheter therapies.

Publication types

Review