Evidence map›Paper›PMID 42331404›Full record

GuidelineJACC. Cardiovascular interventions2026

Mitral Valve Leaflet Modification: A Working Group Position Statement on Best Practices and Step-by-Step Guide.

James M McCabe, Robert J Lederman, David Elison, Greg Condos, Toby Rogers, Amar Krishnaswamy, Frederik Uttenthal, Stephanie Sellers, Prakriti Gaba, Jeremy Rier and 28 more

Abstract readReviewPractice Guideline
PubMed Full text at PMC Publisher
In one paragraph

Guideline in JACC. Cardiovascular interventions, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

38 authors.

James M McCabeDivision of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Center for Innovation in Invasive Cardiology, Boston, Massachusetts, USA. Electronic address: jmccabe4@bidmc.harvard.edu.
Robert J LedermanDivision of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.
David ElisonDivision of Cardiology, University of Washington School of Medicine, Seattle, Washington, USA.
Greg CondosDepartment of Cardiology, Naval Medical Center San Diego, San Diego, California, USA.
Toby RogersDivision of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA; MedStar Washington Hospital Center, Washington, District of Columbia, USA; Georgetown University, Washington, District of Columbia, USA.
Amar KrishnaswamyCleveland Clinic, Cleveland, Ohio, USA.
Frederik UttenthalAalborg University Hospital, Aalborg, Denmark.
Stephanie SellersCardiovascular Translational Laboratory, Providence Research & Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada; Centre for Translational Science and Medtech Innovation, Dilawri Cardiovascular Institute, Vancouver General Hospital, Vancouver, British Columbia, Canada.
Prakriti GabaMass General Brigham, Boston, Massachusetts, USA.
Jeremy RierWellSpan Health York Hospital, York, Pennsylvania, USA.
Brian K WhisenantIntermountain Health, Salt Lake City, Utah, USA.
Paul D MahoneyEast Carolina University, Greenville, North Carolina, USA.
Jeremiah P DeptaMedical College of Wisconsin, Milwaukee, Wisconsin, USA.
Mohamed Abdel-WahabHeart Center Leipzig at Leipzig University, Leipzig, Germany.
Pinak B ShahMass General Brigham, Boston, Massachusetts, USA.
Simon Cheung-Chi LamCardiology Division, Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Cardiology Division, Department of Medicine, Queen Mary Hospital, Hong Kong SAR, China.
Jason R FoerstCarilion Clinic, Roanoke, Virginia, USA.
Isida BykuStructural Heart and Valve Center, Emory University Hospital, Atlanta, Georgia, USA.
Christine J ChungDivision of Cardiology, University of Washington School of Medicine, Seattle, Washington, USA.
Christopher G BruceDivision of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA; WellSpan Health York Hospital, York, Pennsylvania, USA.
Marvin H EngUniversity of Nebraska, Omaha, Nebraska, USA.
Calvin ChoiUniversity of Florida, Jacksonville, Florida, USA.
Roger J LahamDivision of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Paolo DentiSan Raffaele University Hospital, Milan, Italy.
Mayra GuerreroDivision of Cardiology, Mayo Clinic, Rochester, Minnesota, USA.
Ho-On Alston Conrad ChiuCardiology Division, Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Cardiology Division, Department of Medicine, Queen Mary Hospital, Hong Kong SAR, China.
John T SaxonUniversity of Virginia, Charlottesville, Virginia, USA.
Rajaram AnantharamanKauvery Hospital, Chennai, India.
Logan VincentProvidence St. Vincent Medical Center, Portland, Oregon, USA.
Chun-Ka WongCardiology Division, Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Cardiology Division, Department of Medicine, Queen Mary Hospital, Hong Kong SAR, China.
Matteo SaccocciHeart Valve Center, IRCCS San Raffaele Hospital, Milan, Italy; Cardiac Surgery Unit, Poliambulanza Foundation Hospital, Brescia, Italy.
Ander RegueiroClínic Barcelona, University of Barcelona, Barcelona, Spain.
G Burkhard MackensenDepartment of Anesthesia and Pain Medicine, University of Washington, Seattle, Washington, USA.
Ignacio Amat-SantosCardiology Department, University Clinic Hospital, Valladolid, Spain; Centro de Investigación Biomédica en Red - Enfermedades Cardiovasculares, Madrid, Spain.
Adam B GreenbaumStructural Heart and Valve Center, Emory University Hospital, Atlanta, Georgia, USA.
Jaffar M KhanSt. Francis Hospital, Roslyn, New York, USA.
Vasilis C BabaliarosStructural Heart and Valve Center, Emory University Hospital, Atlanta, Georgia, USA.
Phillip FreemanKarolinska University Hospital, Stockholm, Sweden.

Funding

Novel catheter treatment of valve diseaseZIAHL006040 · NHLBI · NATIONAL HEART, LUNG, AND BLOOD INSTITUTE · PI LEDERMAN, ROBERT J · 2010 to 2025
$23.6M
MRI catheter design and fabricationZIAHL006041 · NHLBI · NATIONAL HEART, LUNG, AND BLOOD INSTITUTE · PI LEDERMAN, ROBERT J · 2014 to 2025
$12.2M
Intramural NIH HHS ZIA HL006040Intramural NIH HHS ZIA HL006041
6 · The paper itself

Abstract

Left ventricular outflow tract (LVOT) obstruction is a potentially lethal complication of transcatheter mitral valve replacement (TMVR). The risk for LVOT obstruction can reliably be identified on preprocedural cardiac computed tomography. Intentional LAMPOON (laceration of the anterior mitral leaflet to prevent LVOT obstruction) and related techniques effectively prevent TMVR-induced LVOT obstruction, thereby expanding the treatable patient population. However, perceived technical complexity, the absence of purpose-built devices, and limited training opportunities have hindered the widespread adoption of mitral leaflet modification. This document synthesizes international experience to provide contemporary best-practice guidance for mitral leaflet modification. This state-of-the-art review details transcatheter electrosurgery principles, computed tomography-based risk analysis and procedural planning, a step-by-step guide to the LAMPOON technique, tips for managing uncommon challenges, and guidance on postprocedural care. These contemporary best practices can help operators achieve or maintain proficiency.

Indexed as

ElectrosurgeryMitral ValveMitral Valve AnnuloplastyTranscatheter Mitral Valve ReplacementVentricular Outflow Obstruction, LeftBenchmarkingConsensusHeart Valve ProsthesisHumansPredictive Value of TestsProsthesis DesignRecovery of FunctionRisk AssessmentRisk FactorsTreatment Outcomecomputed tomographyLAMPOONleaflet modificationleft ventricular outflow tract obstructiontranscatheter electrosurgerytranscatheter mitral valve replacement

Identifiers

PMID42331404
PMCPMC13354928

What OpenQuestion holds

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Registered trials

None linked

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.