The First Pediatric LAMPOON Procedure for TMVR (Valve-in-Ring).

BACKGROUND

The LAMPOON (laceration of the anterior mitral leaflet to prevent outflow obstruction) procedure is an innovative transcatheter technique designed to prevent left ventricular outflow tract obstruction during transcatheter mitral valve interventions.

CASE SUMMARY: A 14-year-old male patient with a history of infective endocarditis, previously treated with surgical aortic valve replacement and mitral annuloplasty, presented with severe mitral regurgitation and decompensated heart failure. Owing to prohibitive surgical risk, a transcatheter mitral valve-in-ring replacement (TMViR) was performed with adjunctive LAMPOON to prevent left ventricular outflow tract obstruction. This is to our knowledge the first reported pediatric case of TMViR facilitated by LAMPOON. The procedure was technically successful, and the patient recovered without major complications.

DISCUSSION: This case highlights a novel application of LAMPOON in the pediatric population. Given the absence of surgical options, this approach offers a life-saving, minimally invasive alternative and expands the role of structural interventions in children with complex valvular disease.

TAKE-HOME MESSAGES: LAMPOON can enable safe TMViR in high-risk pediatric patients. Successful outcomes require careful planning, imaging, and multidisciplinary coordination.