LAMPOON Technique and Transapical Wire Externalization During Transcatheter Mitral Valve Replacement.

A 74-year-old woman with failed mitral surgical repair underwent transcatheter mitral valve-in-ring replacement. Pre-procedural assessment highlighted a substantial risk for valve misalignment and left ventricular outflow obstruction. Electrosurgical laceration of the anterior mitral leaflet to prevent outflow obstruction (LAMPOON) technique and transapical wire externalization for valve deployment were successfully employed to prevent these complications.