Trial reportJournal of the American College of Cardiology2019
Anterior Leaflet Laceration to Prevent Ventricular Outflow Tract Obstruction During Transcatheter Mitral Valve Replacement.
Trial report in Journal of the American College of Cardiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT03015194 (NHLBI DIR LAMPOON Study), which is not on this map. Cited by 102 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
NHLBI DIR LAMPOON Study: Intentional Laceration of the Anterior Mitral Leaflet to Prevent Left Ventricular Outflow Tract Obstruction During Transcatheter Mitral Valve Implantation
Who cites it
102 citing papers in PubMed, 4 syntheses or guidelines pooled it, 204 citations in OpenAlex.
- Mitral Valve Leaflet Modification: A Working Group Position Statement on Best Practices and Step-by-Step Guide.JACC. Cardiovascular interventions · 2026Guideline
- Transcatheter mitral valve replacement for degenerated mitral valve bioprostheses, failure of mitral valvuloplasty and native valve with severe mitral annulus calcification: a systematic review and meta-analysis.Journal of cardiothoracic surgery · 2021Pooled it
- Surgical and Transcatheter Mitral Valve Replacement in Mitral Annular Calcification: A Systematic Review.Journal of the American Heart Association · 2021Pooled it
- Reoperative Mitral Surgery Versus Transcatheter Mitral Valve Replacement: A Systematic Review.Journal of the American Heart Association · 2021Pooled it
- 5-Year Outcomes of Anterior Mitral Leaflet Laceration to Prevent Outflow Obstruction.JACC. Cardiovascular interventions · 2024Trial
- Expanding Transcatheter Mitral Valve Replacement Eligibility for ViMAC With a Streamlined BATMAN Leaflet Modification Technique.JACC. Case reports · 2026Article
- Myval Beyond the Aortic Valve: Device-Anatomy Interaction, Procedural Strategy, and Clinical Evidence in Mitral, Tricuspid, and Pulmonary Positions.Bioengineering (Basel, Switzerland) · 2026Review
- Valve-in-Ring TMVR Following Antegrade Base-to-Tip LAMPOON With ELASTIC on VA-ECMO Support: A Case Report.Journal of the Society for Cardiovascular Angiography & Interventions · 2026Article
- Current Evidence, Emerging Evidence, and Decision-Making: An Algorithm for Leaflet Modification Procedures.JACC. Cardiovascular interventions · 2026Review
- Mavacamten Reduces LVOT Obstruction Risk, Enabling Transseptal Mitral Valve-in-Valve for Degenerated Bioprosthesis.JACC. Case reports · 2026Article
- Transcatheter Valve Replacement for Mitral Stenosis: A State of the Art Review.Journal of clinical medicine · 2026Review
- LAMPOON Followed by Valve-in-Valve-in-Ring for Transcatheter Mitral Valve Replacement.CASE (Philadelphia, Pa.) · 2026Article
- Review
- Mitral annular calcification: implications on clinical outcomes and interventions.Annals of cardiothoracic surgery · 2025Review
- Transcatheter mitral valve options for severe mitral annular calcification.Annals of cardiothoracic surgery · 2025Review
- Dynamic left ventricular outflow tract obstruction in critical illness: etiology-driven management and the role of bedside transthoracic echocardiography.Critical care (London, England) · 2025Article
- Annular Reduction by Cinching With TEER in Commissure in Conventionally Inappropriate Ring for Transcatheter Valve.JACC. Case reports · 2025Article
- Transesophageal Echocardiography in Transcatheter Mitral Valve Replacement.Journal of clinical medicine · 2025Review
- Balloon-Assisted Leaflet Translocation in Transcatheter ViMAC: First Experience with the BATMAN Technique in Türkiye.Anatolian journal of cardiology · 2025Article
- Article
42 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Erratum issuedCorrection.2019
Authors and funding
16 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundLeft ventricular outflow tract (LVOT) obstruction is a leading cause of mortality and exclusion from transcatheter mitral valve replacement (TMVR). Intentional laceration of the anterior mitral valve leaflet to prevent LVOT obstruction (LAMPOON) is a transcatheter mimic of surgical chord-sparing leaflet resection.
objectivesThe purpose of this prospective multicenter trial was to study LAMPOON with transseptal (Edwards Lifesciences, Irvine, California) TMVR in annuloplasty rings or native mitral annular calcification (MAC).
methodsSubjects at high or extreme surgical risk and prohibitive risk of LVOT obstruction from TMVR were included. Eligibility was modified midtrial to exclude subjects with threatened LVOT obstruction from a Sapien 3 valve fabric skirt. The primary endpoint was procedure survival with successful LAMPOON, with successful TMVR, without reintervention, and with LVOT gradient <30 mm Hg ("optimal") or <50 mm Hg ("acceptable"). Secondary endpoints included 30-day mortality and major adverse cardiovascular events. There was universal source-data verification and independent monitoring. All endpoints were independently adjudicated. Central laboratories analyzed echocardiogram and CT images.
resultsBetween June 2017 and June 2018, 30 subjects were enrolled equally between the MAC and ring arms. LAMPOON traversal and midline laceration was successful in 100%. Procedure survival was 100%, and 30-day survival was 93%. Primary success was achieved in 73%, driven by additional procedures for paravalvular leak (10%) and high-skirt neo-LVOT gradients observed before a protocol amendment. There were no strokes.
conclusionsLAMPOON was feasible in native and annuloplasty ring anatomies in patients who were otherwise ineligible for treatment, with acceptable safety. LAMPOON was effective in preventing LVOT obstruction from TMVR. Despite LAMPOON, TMVR using Sapien 3 in annuloplasty rings and MAC still exhibits important limitations. (NHLBI DIR LAMPOON Study: Intentional Laceration of the Anterior Mitral Leaflet to Prevent Left Ventricular Outflow Tract Obstruction During Transcatheter Mitral Valve Implantation; NCT03015194).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.