Post-TAVR LVOTO: Contemporary Management and Clinical Outcomes

Transcatheter aortic valve replacement (TAVR) is an established therapy for severe aortic stenosis, yet dynamic left ventricular outflow tract obstruction (LVOTO) remains an uncommon but critical complication. We reviewed published reports of LVOTO after TAVR to delineate clinical patterns, imaging features, and management strategies. LVOTO may be pre-existing and worsen with TAVR or arise de novo after relief of valvular afterload. Emerging data suggests that septal hypertrophy, small left ventricular cavity size, and adverse mitral-septal geometry may identify patients at risk. Management is individualised and includes medical optimisation, atrioventricular pacing, alcohol septal ablation, and transcatheter edge-to-edge mitral repair. An imaging-guided approach may support earlier recognition, risk stratification and management of this rare but severe post-TAVR complication.