{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:37Z","timestamp":1753876237196,"version":"3.41.2"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T00:00:00Z","timestamp":1737504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Transcatheter mitral valve replacement (TMVR) has become a viable, minimally invasive treatment for inoperable patients with severe mitral valve disease, particularly among elderly individuals with significant comorbidities. A key complication of TMVR is left ventricular outflow tract (LVOT) obstruction, necessitating various preventive and therapeutic strategies. This report presents a case of severe LVOT obstruction following TMVR and highlights the effective application of the kissing balloon technique as a therapeutic intervention.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 79-year-old female with New York Heart Association Class IV dyspnoea due to severe mitral stenosis and a high operative risk, with a Society of Thoracic Surgeons Risk of Mortality (STS-PROM) score of 6.2%, underwent TMVR. Pre-procedural evaluations indicated significant mitral valve calcification and a mitral valve area of 0.9\u2005cm\u00b2. After successful TMVR deployment, post-implantation echocardiography revealed an LVOT pressure gradient of 53\/85\u2005mmHg, prompting the use of the kissing balloon technique, which reduced the gradient to 28\u2005mmHg. Follow-up assessments showed normal mitral valve function and stable LVOT gradients during short-term follow-up throughout the patient\u2019s hospital stay.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Left ventricular outflow tract obstruction is a potentially life-threatening complication of TMVR, often associated with high mortality rates due to haemodynamic impairment. This complication can arise from various anatomical factors and valve positioning issues. Several strategies have been developed to address LVOT obstruction, including the laceration of the anterior mitral leaflet and alcohol septal ablation. The successful implementation of the kissing balloon technique in this case underscores its potential to improve outcomes in LVOT obstruction.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf021","type":"journal-article","created":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T06:42:11Z","timestamp":1737528131000},"source":"Crossref","is-referenced-by-count":0,"title":["Kissing balloon technique as rescue strategy to treat left ventricular outflow tract obstruction after transcatheter mitral valve replacement: a case report"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3687-5410","authenticated-orcid":false,"given":"Sibel","family":"\u00c7atalkaya","sequence":"first","affiliation":[{"name":"Department of Cardiology, Bursa City Hospital , Do\u011fank\u00f6y Mahallesi \u015eifa Caddesi No:1 16250 Nil\u00fcfer\/Bursa ,","place":["Turkey"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hakan","family":"Erkan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bursa City Hospital , Do\u011fank\u00f6y Mahallesi \u015eifa Caddesi No:1 16250 Nil\u00fcfer\/Bursa ,","place":["Turkey"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,1,22]]},"reference":[{"key":"2025020715453669700_ytaf021-B1","doi-asserted-by":"crossref","first-page":"2175","DOI":"10.1016\/j.jacc.2017.02.045","article-title":"Transcatheter mitral valve replacement: insights from early clinical experience and future challenges","volume":"69","author":"Regueiro","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"2025020715453669700_ytaf021-B2","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1016\/j.jcin.2019.03.029","article-title":"Trouble after transcatheter mitral valve replacement: anticipate, innovate, refine","volume":"12","author":"Tuzcu","year":"2019","journal-title":"JACC Cardiovasc Interv"},{"key":"2025020715453669700_ytaf021-B3","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1093\/eurheartj\/ehy590","article-title":"Outcomes of transcatheter mitral valve replacement for degenerated bioprostheses, failed annuloplasty rings, and mitral annular calcification","volume":"40","author":"Yoon","year":"2019","journal-title":"Eur Heart J"},{"key":"2025020715453669700_ytaf021-B4","doi-asserted-by":"crossref","first-page":"e008425","DOI":"10.1161\/CIRCINTERVENTIONS.119.008425","article-title":"Thirty-day outcomes of transcatheter mitral valve replacement for degenerated mitral bioprostheses (valve-in-valve), failed surgical rings (valve-in-ring), and native valve with severe mitral annular calcification (valve-in-mitral annular calcification) in the United States: data from the Society of Thoracic Surgeons\/American College of Cardiology\/Transcatheter Valve Therapy Registry","volume":"13","author":"Guerrero","year":"2020","journal-title":"Circ Cardiovasc Interv"},{"key":"2025020715453669700_ytaf021-B5","doi-asserted-by":"crossref","first-page":"172","DOI":"10.21037\/acs-2020-mv-25","article-title":"LAMPOON techniques to prevent or manage left ventricular outflow tract obstruction in transcatheter mitral valve replacement","volume":"10","author":"Case","year":"2021","journal-title":"Ann Cardiothorac Surg"},{"key":"2025020715453669700_ytaf021-B6","doi-asserted-by":"crossref","first-page":"1932","DOI":"10.1016\/j.jcin.2017.08.014","article-title":"Early outcomes of percutaneous transvenous transseptal transcatheter valve implantation in failed bioprosthetic mitral valves, ring annuloplasty, and severe mitral annular calcification","volume":"10","author":"Eleid","year":"2017","journal-title":"JACC Cardiovasc Interv"},{"key":"2025020715453669700_ytaf021-B7","doi-asserted-by":"crossref","first-page":"1841","DOI":"10.1016\/j.jacc.2018.02.054","article-title":"1-year outcomes of transcatheter mitral valve replacement in patients with severe mitral annular calcification","volume":"71","author":"Guerrero","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2025020715453669700_ytaf021-B8","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1016\/j.jcmg.2016.01.005","article-title":"Predicting LVOT obstruction in transcatheter mitral valve implantation: concept of the neo-LVOT","volume":"10","author":"Blanke","year":"2017","journal-title":"JACC Cardiovasc Imaging"},{"key":"2025020715453669700_ytaf021-B9","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1016\/j.jcmg.2018.04.005","article-title":"Predicting left ventricular outflow tract obstruction despite anterior mitral leaflet resection: the \u201cskirt NeoLVOT\u201d","volume":"11","author":"Khan","year":"2018","journal-title":"JACC Cardiovasc Imaging"},{"key":"2025020715453669700_ytaf021-B10","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1016\/j.jcin.2019.02.034","article-title":"Alcohol septal ablation to prevent left ventricular outflow tract obstruction during transcatheter mitral valve replacement: first-in-man study","volume":"12","author":"Wang","year":"2019","journal-title":"JACC Cardiovasc Interv"},{"key":"2025020715453669700_ytaf021-B11","doi-asserted-by":"crossref","first-page":"2220","DOI":"10.1093\/eurheartj\/ehy112","article-title":"Kissing balloon technique to secure the neo-left ventricular outflow tract in transcatheter mitral valve implantation","volume":"39","author":"Rahhab","year":"2018","journal-title":"Eur Heart J"},{"key":"2025020715453669700_ytaf021-B12","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1002\/ccd.27068","article-title":"Novel use of perfusion balloon inflation to avoid outflow tract obstruction during transcatheter mitral valve-in-valve replacement","volume":"92","author":"Herrmann","year":"2018","journal-title":"Catheter Cardiovasc Interv"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytaf021\/61538390\/ytaf021.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/2\/ytaf021\/61538390\/ytaf021.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/2\/ytaf021\/61538390\/ytaf021.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T15:46:03Z","timestamp":1738943163000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytaf021\/7966731"}},"subtitle":[],"editor":[{"given":"Rita","family":"Pavasini","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Ivan","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Nidhi","family":"Madan","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Elton","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,1,22]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaf021","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2025,2]]},"published":{"date-parts":[[2025,1,22]]},"article-number":"ytaf021"}}