What question did this study set out to answer?

To evaluate the safety and effectiveness of the LAMPOON technique in transcatheter mitral valve replacement (TMVR) in complex cases.

February 28, 2026CASE0 citationsOpen Access

LAMPOON Followed by Valve-in-Valve-in-Ring for Transcatheter Mitral Valve Replacement

ASAshleigh N Shenton NCNicholas Chan HSHanyuan Shi

Key Result

LAMPOON is safe and effective for preventing left ventricular outflow tract obstruction even in complex valve-in-valve-in-ring transcatheter mitral valve replacement cases.

Key Points

To evaluate the safety and effectiveness of the LAMPOON technique in transcatheter mitral valve replacement (TMVR) in complex cases.
Assessment of LVOTO risk related to mitral leaflet length during TMVR.
Implementation of LAMPOON technique in ViViR cases.
Evaluation of patient outcomes post-procedure.
LAMPOON shows safety in cases with increased LVOTO risk linked to long mitral leaflets.
Efficacy of LAMPOON is confirmed even in complex ViViR scenarios.
LAMPOON may enhance accessibility of TMVR for patients with complicated clinical profiles.

Structured PICO

Population

81-year-old man with severe mitral regurgitation, prior CABG with mitral P2 resection and 30-mm annuloplasty ring, reduced ejection fraction (45-50%), and high surgical risk (STS mortality 10.9%).

Intervention

LAMPOON (laceration of the anterior mitral leaflet to prevent outflow obstruction) procedure followed by Valve-in-Valve-in-Ring (ViViR) transcatheter mitral valve replacement (initial 29-mm valve followed by a 26-mm valve).

Outcome

Procedural success (reduction of paravalvular leak and prevention of left ventricular outflow tract obstruction)

This case demonstrates the feasibility of using a valve-in-valve-in-ring TMVR approach to treat paravalvular leak following a LAMPOON procedure in a high-risk patient with a prior annuloplasty ring.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

• Risk for LVOTO after MV replacement increases with mitral leaflet length. • LAMPOON is safe and effective even in ViViR cases. • LAMPOON may play a role in increasing accessibility of TMVR to complex patients. Figure: see text

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Cite This Study

Shenton et al. (Tue,) reported a other. LAMPOON is safe and effective for preventing left ventricular outflow tract obstruction even in complex valve-in-valve-in-ring transcatheter mitral valve replacement cases.

synapsesocial.com/papers/6a025a579cddff7633412b6a https://doi.org/https://doi.org/10.1016/j.case.2025.11.009

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