Related Experiment Video
Updated: May 13, 2026

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Prevention of Bilateral Coronary Obstruction During Valve-In-Valve TAVR With a Self-Expanding Valve: The BABICORN
Ahmed Ghoneem1, Mubashir Mumtaz2, Arun Kanmanthareddy1
1Department of Cardiovascular Medicine, University of Pittsburgh Medical Center, Harrisburg, Pennsylvania, USA.
Objective:
We present a case of valve-in-valve transcatheter aortic valve replacement in an 85-year-old woman with severe bioprosthetic aortic valve stenosis at a high risk of left and right coronary artery obstruction. This risk was mitigated by a procedure combining both BASILICA and UNICORN (BABICORN [Bileaflet Alteration with BASILICA and Iatrogenic Cusp Obliteration Using Radiofrequency Needle]) for double leaflet modification.
Key Steps:
Electrosurgical traversal of the right leaflet and creating the electrosurgical loop using 2 guide catheters and an Astato wire within. Electrosurgical traversal of the left leaflet and ballooning the leaflet fenestration. Creating the flying V and lacerating the right leaflet. Serial ballooning and ultimately lacerating the left leaflet. Deployment of the Evolut valve.
Potential Pitfalls:
Catheter entanglement, inadequate leaflet laceration, and stroke or systemic embolization.
Take-Home Message:
The BABICORN procedure for double leaflet modification before valve-in-valve transcatheter aortic valve replacement with a self-expanding valve is technically feasible and preserves coronary flow in both native arteries.
More Related Videos
14:14Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
05:31Transcatheter Pulmonary Valve Replacement from Autologous Pericardium with a Self-Expandable Nitinol Stent in an Adult Sheep Model
Published on: June 8, 2022
Related Concept Videos
Mitral Stenosis III: Medical Management
Aortic Regurgitation III: Medical Management