scholarly journals Intentional transcatheter laceration of the coronary cusp to prevent left main stem obstruction during transcatheter aortic valve implantation: first European experience with the BASILICA technique in a native aortic valve

2018 ◽  
Vol 40 (17) ◽  
pp. 1384-1385 ◽  
Author(s):  
A Markus Kasel ◽  
Jaffar M Khan ◽  
Adam B Greenbaum ◽  
Jonathan M Michel
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Main Stem ◽  
Left Main ◽  
Transcatheter Aortic Valve ◽  
Left Main Stem ◽  
European Experience ◽  
Aortic Valve Implantation ◽  
Coronary Cusp ◽  
Valve Implantation

Transcatheter Aortic Valve Implantation into a Stentless Prosthetic Valve with a Low Position of the Left Main Coronary Artery

2012 ◽  
Vol 15 (5) ◽  
pp. 268
Author(s):  
Giuseppe D'Ancona ◽  
Miralem Pasic ◽  
Stephan Dreysse ◽  
Thorsten Drews ◽  
Semih Buz ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Left Main Coronary Artery ◽  
High Risk Patient ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Left Main ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Recently during a transcatheter aortic valve implantation (TAVI), we were faced with a problem that seemed to be untreatable by TAVI. It was difficult to decide whether to perform atypical TAVI or to convert to conventional redo aortic valve surgery in an extremely high-risk patient with a degenerated stentless aortic bioprosthesis.

scholarly journals Prevention of coronary obstruction in patients at risk undergoing transcatheter aortic valve implantation: the Hamburg BASILICA experience

2021 ◽  
Author(s):  
Dirk Westermann ◽  
Sebastian Ludwig ◽  
Daniel Kalbacher ◽  
Clemens Spink ◽  
Matthias Linder ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Individual Risk ◽  
Aortic Valves ◽  
Effective Prevention ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Coronary Cusp ◽  
Valve Implantation ◽  
Coronary Obstruction

Abstract Objectives This study aimed to assess the clinical outcome of the bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary obstruction (BASILICA) technique in a single-center patient cohort considered at high or prohibitive risk of transcatheter aortic valve implantation (TAVI)-induced coronary obstruction. Methods Between October 2019 and January 2021, a total of 15 consecutive patients (age 81.0 [78.1, 84.4] years; 53.3% female; EuroSCORE II 10.6 [6.3, 14.8] %) underwent BASILICA procedure prior to TAVI at our institution. Indications for TAVI were degeneration of stented (n = 12, 80.0%) or stentless (n = 1, 6.7%) bioprosthetic aortic valves, or calcific stenosis of native aortic valves (n = 2, 13.3%), respectively. Individual risk of TAVI-induced coronary obstruction was assessed by pre-procedural computed tomography analysis. Procedural and 30-day outcomes were documented in accordance with Valve Academic Research Consortium (VARC)-2 criteria. Results BASILICA was attempted for single left coronary cusp in 12 patients (80.0%), for single right coronary cusp in 2 patients (13.3%), and for both cusps in 1 patient (6.7%), respectively. The procedure was feasible in 13 patients (86.7%) resulting in effective prevention of coronary obstruction, whilst TAVI was performed without prior successful bioprosthetic leaflet laceration in two patients (13.3%). In one of these patients (6.7%), additional chimney stenting immediately after TAVI was performed. No all-cause deaths or strokes were documented after 30 days. Conclusion The BASILICA technique appears to be a feasible, safe and effective concept to avoid iatrogenic coronary artery obstruction during TAVI in both native and bioprosthetic valves of patients at high or prohibitive risk. ClinicalTrials.gov Identifier: NCT04227002 (Hamburg AoRtic Valve cOhoRt).

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