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

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

^*Correspondence: roiestevez@hotmail.com; rodrigo.estevez.loureiro@sergas.es (Rodrigo Estévez-Loureiro)

Rev. Cardiovasc. Med. 2024, 25(4), 134; https://doi.org/10.31083/j.rcm2504134

Submitted: 6 November 2023 | Revised: 23 January 2024 | Accepted: 29 January 2024 | Published: 3 April 2024

(This article belongs to the Special Issue New Perspectives of Valvulopathy)

This is an open access article under the CC BY 4.0 license.

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

mitral regurgitation

transcatheter therapies

left ventricular outflow tract obstruction

management

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Rev. Cardiovasc. Med. Print ISSN 1530-6550 Electronic ISSN 2153-8174