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. Author manuscript; available in PMC: 2017 Jun 20.
Published in final edited form as: JACC Cardiovasc Interv. 2016 Sep 12;9(17):1835–1843. doi: 10.1016/j.jcin.2016.06.020

FIGURE 5. Benchtop Assessment of Left Ventricular Outflow Tract Geometry Impact.

FIGURE 5

The base of the left ventricle is viewed in cross section after the apex is cut away. (A) A naive heart with the anterior mitral leaflet intact. The trajectory of an intentional laceration of the anterior mitral valve leaflet to prevent left ventricular outflow tract obstruction (LAMPOON) laceration is depicted by the dashed line. (B) Transcatheter mitral valve replacement (TMVR) with intact anterior leaflet showing reduced left ventricular outflow tract (LVOT) area. (C) LAMPOON modification made to the same heart, with the anterior leaflets displaced to the side by TMVR and reduced LVOT obstruction. Flow would be possible through uncovered stent struts. (D) Explant after in vivo LAMPOON heart showing lacerated anterior leaflet. (E) TMVR in the explanted heart after LAMPOON showing displacement of the anterior leaflet away from the LVOT. (F) Explanted heart after isolated in vivo LAMPOON viewed from the posterior wall, showing central laceration down the complete length of the anterior leaflet. The intact subvalvular apparatus displaces the leaflet tips away from the LVOT. LVOT = left ventricular outflow tract; MVO = mitral valve orifice.