Neo-LVOT and Transcatheter Mitral Valve Replacement Expert Recommendations

With the advent of transcatheter mitral valve replacement (TMVR), the concept of the neo-left ventricular outflow tract (LVOT) was introduced and remains an essential component of treatment planning. This paper describes the LVOT anatomy and provides a step-by-step computed tomography methodology to segment and measure the neo-LVOT while discussing the current evidence and outstanding challenges. It also discusses the technical and hemodynamic factors that play a major role in assessing the neo-LVOT. A summary of expert-based recommendations about the overall risk of LVOT obstruction in different scenarios is presented along with the currently available methods to reduce the risk of LVOT obstruction and other post-procedural complications. (C) 2021 by the American College of Cardiology Foundation.

Automated summary

This paper discusses the concept of neo-left ventricular outflow tract (LVOT) in transcatheter mitral valve replacement (TMVR) and provides a step-by-step computed tomography methodology to segment and measure the neo-LVOT. It also examines the technical and hemodynamic factors in assessing the neo-LVOT, along with expert recommendations on reducing the risk of LVOT obstruction and post-procedural complications.