A super alternative: BATMAN helps cardiologists limit complications during TMVR
Balloon-assisted anterior mitral leaflet modification (BATMAN) is a safe, effective way to prevent left ventricular outflow track (LVOT) obstruction during high-risk transcatheter mitral valve replacement (TMVR) procedures, according to new data presented at SCAI 2025 Scientific Sessions, the annual meeting of the Society for Cardiovascular Angiography and Interventions (SCAI).
LVOT obstruction is a complication of TMVR linked to an increased risk of heart failure or even patient mortality. The BATMAN technique can help limit the risk of LVOT obstruction, but clinical data on its safety and effectiveness are limited. The team behind this study aimed to learn more, tracking data from 21 patients with a median Society of Thoracic Surgeons score for mortality of 19.4%.
All patients were treated using the BATMAN technique. One-third of patients were treated with a valve-in-valve (ViV) approach, one-third were treated with a valve-in-ring approach and one-third were treated with a valve-in-mitral annular calcification (ViM) approach.
Lead author Gennaro Giustino, MD, an interventional cardiologist with Morristown Medical Center, presented his team’s findings. Overall, successful TMVR with freedom from LVOT obstruction was seen in 92.7% of patients. The median time between leaflet traversal and laceration was 16 minutes and the median time between leaflet laceration and valve implantation was 10 minutes.
The study’s primary safety endpoint, a composite of in-hospital death, stroke or major cardiac structural complications, was seen in 9.8% of patients. This included two deaths from the ViM group and another death from the ViV group, but no structural complications or strokes.
“Traditionally, the LAMPOON technique and its various iterations has been used to enable TMVR in patients at high risk of LVOT obstruction; however, this technique has a steep learning curve and is technically more challenging and time-consuming,” Giustino said in a statement. “The findings from this study highlight that BATMAN may be considered as an alternative to LAMPOON associated with excellent efficacy and safety, particularly for ViR and ViV procedures, providing another option for physicians."
Additional details about the session are available here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.