Modified Transseptal BATMAN for Anterior Leaflet Modification in High-Risk Transcatheter Mitral Valve-in-Valve Replacements: A Case Series.

The BATMAN (Balloon-Assisted Translocation of the Mitral Anterior leaflet) technique, a novel approach for modifying the anterior leaflet during transcatheter mitral valve replacement (TMVR), has recently demonstrated efficacy in preventing left ventricular outflow tract obstruction (LVOT) which constitutes a high-risk complication in valve-in-valve TMVR procedures. We describe three complex cases of severe bioprosthetic mitral stenosis who underwent successful valve-in-valve TMVR utilizing a modified transseptal BATMAN technique. We highlight the procedural methodology and explore the potential for this technique to be standard of care for valve-in-valve TMVR.