Tip-to-Base LAMPOON to Prevent Left Ventricular Outflow Tract Obstruction in Valve-in-Valve Transcatheter Mitral Valve Replacement

An 84-year-old woman with a history of a 29-mm bioprosthetic Mosaic (Medtronic, Minneapolis, Minnesota) mitral valve replacement presented with heart failure. Transesophageal echocardiography (TEE) demonstrated severe regurgitation ([Figure 1A][1]) from torn prosthetic leaflets ([Figure 1B][1]).