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JACC. Cardiovascular interventions · 2026

Balloon-Assisted Translocation of the Mitral Anterior Leaflet to Prevent Outflow Tract Obstruction During TMVR: The BATMAN Registry.

СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Giustino Gennaro, Beneduce Alessandro, Fam Neil, Jabri Ahmad, Eng Marvin, Garcia Santiago, Al-Azizi Karim, Dahle Thom, Ninios Vlasis, El Sabbagh Abdallah, Naik Hursh, Mangieri Antonio, Regueiro Ander, De Marco Federico, Vora Amit, Guerrini Marco, Tayal Raj, Bavishi Chirag, Latib Azeem, Kolte Dhaval, Basman Craig, O'Neill Brian, Denti Paolo, Halboni Adnan, Alnasser Sami, Abbas Amr, Guddeti Raviteja, Aqtash Obadah, Stegman Brian, Asselin Chantal, Papadopoulos Georgios, Dakroub Ali H, Kumar Sant, Tartaglia Francesco, Kidd Stephen, Akintoye Emmanuel, Leone Pier Pasquale, Frisoli Tiberio, Engel Pedro, Lok Lai Leo Kar, Fang Jonathan X, Seshiah Puvi, Buzzatti Nicola, Saccocci Matteo, Sakhuja Rahul, Forrest John K, Kaple Ryan, Koulogiannis Konstantinos, Kipperman Robert, Colombo Antonio, O'Neill William, Helmy Tarek, Genereux Philippe, Maisano Francesco, Villablanca Pedro A

Аннотация

BACKGROUND: BATMAN (balloon-assisted translocation of the mitral anterior leaflet) is an increasingly adopted technique to modify the anterior mitral leaflet (AML) and prevent left ventricular outflow tract (LVOT) obstruction during transcatheter mitral valve replacement (TMVR).

OBJECTIVES: The aim of this study was to evaluate the feasibility, efficacy, and safety of the BATMAN technique during transseptal TMVR.

METHODS: This was an international, multicenter cohort study of all consecutive patients at high risk for LVOT obstruction undergoing transseptal BATMAN TMVR for valve-in-valve (ViV), valve-in-ring (ViR) and valve-in-mitral annular calcification (ViMAC) at 22 structural heart disease centers in North America and Europe. The primary efficacy endpoint was the rate of successful TMVR free from LVOT obstruction and procedural death. The primary safety endpoint was the in-hospital composite of death, stroke, or major cardiac structural complications.

RESULTS: A total of 83 patients were included: 24 undergoing ViV, 39 ViR, and 19 ViMAC procedures. Technical success was achieved in all but 1 case (98.8%) that was converted to tip-to-base LAMPOON (laceration of the anterior mitral leaflet to prevent outflow obstruction). Pre-emptive mechanical cardiocirculatory support was used in 28.9% of cases. The primary efficacy endpoint was met in 95.1% of cases (100% in ViR, 95.8% in ViV, and 84.2% of ViMAC; P = 0.03). The primary safety endpoint occurred in 7.3% of patients and was higher in the ViMAC group (0% in ViR, 8.3% in ViV, and 21.1% in ViMAC; P = 0.02). There was 1 major cardiac structural complication directly attributed to BATMAN in a ViMAC patient.

CONCLUSIONS: BATMAN was associated with high technical success and effectiveness in preventing LVOT obstruction and appeared to be safe in ViR and ViV procedures. Adverse events were higher in ViMAC.

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