Unusual Cause of Left Ventricular Outflow Tract Obstruction Following Transcatheter Mitral Valve-in-Ring Replacement.

• Causes of LVOT obstruction after transcatheter mitral valve-in-ring replacement. • Unusual cause contributing to obstruction in this case. • Importance of procedural planning to predict and minimize risk for LVOT obstruction. • Role of TEE in diagnosis and in directing therapy when this complication occurs. • Role of noninvasive techniques to prevent and treat LVOT obstruction.