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Although the safety and efficacy of transcatheter edge-to-edge mitral valve repair (TEER) is well-established, there is a sense amongst innovators that a major advantage of TMVR may be to offer a more complete solution for the correction of MR in patients whose complex anatomy means that the likelihood of achieving grade 0 or 1 MR with TEER is low. However, abrupt correction of MR in a poorly prepared left ventricle poses a number of unique haemodynamic challenges, particularly when sudden elimination of regurgitant flow causes a relative increase in left ventricular (LV) afterload. Rapid reduction in LV cavity size following MR elimination may itself result in relative LV outflow tract obstruction (LVOTO), irrespective of the intrinsic risk of LVOTO associated with TMVR. Nevertheless, TMVR on a beating heart affords the opportunity to study real-time invasive cardiac indices in high-risk patients with acute reversal of severe MR.<\/jats:p>","DOI":"10.1002\/ejhf.2758","type":"journal-article","created":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T06:50:47Z","timestamp":1671087047000},"page":"890-901","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Peri-Procedural Management of Transcatheter Mitral Valve Replacement in Patients with Heart Failure"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0040-7719","authenticated-orcid":false,"given":"Sara L.","family":"Hungerford","sequence":"first","affiliation":[{"name":"St Vincent's Hospital Clinical School, Faculty of Medicine, University of New South Wales , Sydney ,","place":["Australia"]},{"name":"Department of Cardiology, Royal North Shore Hospital , Sydney ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gry","family":"Dahle","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Oslo University Hospital , Oslo ,","place":["Norway"]},{"name":"Oslo University , Oslo ,","place":["Norway"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison","family":"Duncan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Brompton Hospital , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher S.","family":"Hayward","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital Clinical School, Faculty of Medicine, University of New South Wales , Sydney ,","place":["Australia"]},{"name":"Department of Cardiology, St Vincent's Hospital , Sydney ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David 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