Neo-LVOT and Transcatheter Mitral Valve Replacement: Expert Recommendations

Anna Reid, Sagit Ben Zekry, Mansi Turaga, Stephanie Tarazi, Jeroen J. Bax, Dee Dee Wang, Nicolo Piazza, Vinayak N. Bapat, Abdul Rahman Ihdayhid, João L. Cavalcante, Philipp Blanke, Jonathon Leipsic*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


With the advent of transcatheter mitral valve replacement (TMVR), the concept of the neo–left ventricular outflow tract (LVOT) was introduced and remains an essential component of treatment planning. This paper describes the LVOT anatomy and provides a step-by-step computed tomography methodology to segment and measure the neo-LVOT while discussing the current evidence and outstanding challenges. It also discusses the technical and hemodynamic factors that play a major role in assessing the neo-LVOT. A summary of expert-based recommendations about the overall risk of LVOT obstruction in different scenarios is presented along with the currently available methods to reduce the risk of LVOT obstruction and other post-procedural complications.

Original languageEnglish
Pages (from-to)854-866
Number of pages13
JournalJACC: Cardiovascular Imaging
Issue number4
StatePublished - Apr 2021
Externally publishedYes


  • LVOT
  • LVOT obstruction
  • neo-LVOT
  • transcatheter mitral valve replacement


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