Modified Lampoon-Procedure for Transapical Mitral Valve Replacement Using the Tendyne Device – a Novel Treatment Modality in Patients not Eligible for Open-Heart Surgery

Transcatheter, transapical mitral valve replacement ( TMVR) using the Tendyne© device (Abbott Labo ratories, Abbott Park, Illinois, USA) is a novel technique to treat severe mitral regurgitation ( MR) without the use of cardiopul monary bypass or sternotomy, which can be advantageous for older patients with multiple comorbidities. However, a poten tial complication of TMVR includes the dynamic obstruction of the left ventricular outflow tract ( LVOT) by the native anterior mitral valve leaflet ( AMVL), which may result in systolic ante rior motion ( SAM). Anatomical characteristics that are associ ated with a dynamic obstruction are identified during the (pre) screening process. These patients are not eligible for TMVR. Up to 31.7% (Ludwig et al.) of (pre)screening failures are due to the fear of LVOT occlusion.