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. 2026 Jan 6;6(1):1–15. doi: 10.1016/j.jacasi.2025.10.025

Figure 4.

Figure 4

Antegrade Base-to-Tip LAMPOON Technique

(A) Two transseptal steerable sheaths are placed in the left atrium, one for delivering Astato wire for traversing the A2 segment of the anterior mitral valve leaflet; and another one for positioning the EN Snare in the LVOT. (B) After leaflet traversal, the Astato is snared and externalized. (C) Astato wire in “flying V” configuration is used to lacerate the anterior mitral valve leaflet. (D) “Flying V” shown on transesophageal echocardiography. Abbreviations as in Figure 1.