Aortic valve leaflet disruption techniques in transcatheter aortic valve replacement.

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Devices

Background:

• Transcatheter aortic valve replacement (TAVR) is a minimally invasive treatment for aortic valve stenosis, expanding treatment options for a broader patient population.
• A significant complication of TAVR is iatrogenic coronary artery obstruction, where displaced native aortic valve leaflets occlude the coronary ostia.

Purpose of the Study:

• To introduce and evaluate the Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction (BASILICA) technique.
• To assess the safety and efficacy of BASILICA in preventing coronary artery obstruction during TAVR.

Main Methods:

• The BASILICA technique involves creating a lengthwise laceration of aortic valve leaflets prior to TAVR implantation.
• This procedure aims to prevent the displacement of native leaflets into the coronary artery orifices.

Main Results:

• Patient outcomes following TAVR with the BASILICA technique have demonstrated promising results.
• The technique effectively mitigates the risk of coronary artery obstruction associated with TAVR.

Conclusions:

• BASILICA is a valuable technique for preventing iatrogenic coronary artery obstruction in TAVR procedures.
• Continued refinement and meticulous patient selection are crucial for optimizing TAVR outcomes in high-risk patients.