Jaffar Khan (NHLBI)
Toby Rogers (NHLBI)
Left ventricular outflow tract obstruction is a life-threatening complication of transcatheter mitral valve replacement caused by septal displacement of the anterior mitral leaflet (AML). The AML is a mobile structure that physically separates inflow and outflow zones of the left ventricle. Preserving the AML during surgical mitral valve replacement can cause left ventricular outflow tract obstruction, either when the prosthesis struts protrude into the left ventricular outflow tract or when along redundant anterior leaflet prolapses into the left ventrical outflow tract. The invention relates to devices having monopolar or bipolar tissue lacerators for efficiently and safely cutting AMLs percutaneously by vaporizing target tissue with electrical energy. Exemplary devices include a wire partially covered by electrical insulation, where the wire is kinked and where the wire is exposed through the insulation at one or more exposed regions along or near the inner curvature of the kink. The wire is configured to conduct electrical energy through the exposed region(s) and through a tissue target positioned adjacent the inner curvature to lacerate the tissue target via the electrical energy. The tissue target can be a native or prosthetic heart valve leaflet in a patient's heart. An optional feature of the device also includes an irrigation catheter to displace blood from the electrode, concentrating current at the tissue and reducing char and coagulum formation.
- Prevention of iatrogenic left ventricular outflow tract obstruction following transcatheter mitral valve replacement
- Bioprosthetic aortic scallop intentional laceration