JACC. Case reports · 2026
BATMAN-Assisted Valve-in-Valve TMVR With Planned Hemodynamic Support in Severe Pulmonary Hypertension.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Saeed Moiz, Sabanci Rand, Ghumman Ghulam Mujtaba, Tahir Ayesha, Baqi Abdul, Noman Anas, Taleb Mohammed
Аннотация
BACKGROUND: Left ventricular outflow tract (LVOT) obstruction is a feared complication of transcatheter mitral valve replacement (TMVR), and balloon-assisted translocation of the mitral anterior leaflet (BATMAN) has emerged as a mitigation strategy. Patients with severe pulmonary hypertension are at risk, as abrupt elimination of mitral regurgitation (MR) can destabilize hemodynamics.
CASE SUMMARY: A 78-year-old woman with a degenerated 25-mm surgical bioprosthesis, severe pulmonary hypertension (mean pulmonary artery pressure 65 mm Hg), and reduced cardiac index (1.9 L/min/m2) underwent transseptal BATMAN-assisted valve-in-valve TMVR using a 23-mm SAPIEN 3 Resilia valve with planned intra-aortic balloon pump (IABP) support. A computed tomography-predicted neo-LVOT area of 181 mm2 guided anterior leaflet modification. MR was eliminated with a mean transmitral gradient of 1 mm Hg, no LVOT obstruction, and stable periprocedural hemodynamics.
DISCUSSION: BATMAN enabled successful TMVR despite high-risk anatomy. Prophylactic IABP facilitated hemodynamic stability during the transition from chronic MR physiology. This is among the first reports combining planned mechanical circulatory support with BATMAN-assisted TMVR in severe pulmonary hypertension.
TAKE-HOME MESSAGE: BATMAN-assisted valve-in-valve TMVR with planned IABP support may facilitate safe treatment of selected patients with severe pulmonary hypertension and predicted LVOT obstruction.
CASE SUMMARY: A 78-year-old woman with a degenerated 25-mm surgical bioprosthesis, severe pulmonary hypertension (mean pulmonary artery pressure 65 mm Hg), and reduced cardiac index (1.9 L/min/m2) underwent transseptal BATMAN-assisted valve-in-valve TMVR using a 23-mm SAPIEN 3 Resilia valve with planned intra-aortic balloon pump (IABP) support. A computed tomography-predicted neo-LVOT area of 181 mm2 guided anterior leaflet modification. MR was eliminated with a mean transmitral gradient of 1 mm Hg, no LVOT obstruction, and stable periprocedural hemodynamics.
DISCUSSION: BATMAN enabled successful TMVR despite high-risk anatomy. Prophylactic IABP facilitated hemodynamic stability during the transition from chronic MR physiology. This is among the first reports combining planned mechanical circulatory support with BATMAN-assisted TMVR in severe pulmonary hypertension.
TAKE-HOME MESSAGE: BATMAN-assisted valve-in-valve TMVR with planned IABP support may facilitate safe treatment of selected patients with severe pulmonary hypertension and predicted LVOT obstruction.