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Current Evidence, Emerging Evidence, and Decision-Making: An Algorithm for Leaflet Modification Procedures
Adam B Greenbaum1, John T D'Angelo1, Robert J Lederman2
1Structural Heart and Valve Center, Emory University Hospital, Atlanta, Georgia, USA.
JACC. Cardiovascular Interventions
|June 9, 2026
Summary
Leaflet modification techniques are crucial for structural interventionalists. New algorithms guide the selection of aortic and mitral leaflet modification procedures based on patient anatomy and pathology.
Area of Science:
- Cardiovascular intervention
- Structural heart disease management
Background:
- Leaflet modification is essential for structural interventionalists.
- Existing leaflet splitting techniques have limitations in extreme cases.
- Emerging intraleaflet techniques offer broader applicability but raise safety concerns.
Purpose of the Study:
- To propose systematic algorithms for aortic and mitral leaflet modification.
- To guide structural operators in selecting appropriate leaflet modification approaches.
Main Methods:
- Development of systematic algorithms for leaflet modification procedures.
- Consideration of patient anatomy, pathology, and procedural goals in algorithm design.
Main Results:
- Algorithms provide a structured approach to leaflet modification.
- Guidance for selecting between leaflet splitting and intraleaflet techniques.
Conclusions:
- Systematic algorithms can aid in optimizing leaflet modification procedures.
- These algorithms support informed decision-making for structural interventionalists.
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