Related Experiment Video
Updated: Jan 18, 2026
Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
BICORN (Bilateral Iatrogenic Coronary Obstruction Risk Nullification) Procedure for Transcatheter Aortic
Tariq Ahmad1, Vernon Mascarenhas1, Terry Bauch1
1Richard & Marion Pearsall Heart Hospital, Geisinger Health System, Wilkes-Barre, Pennsylvania, USA.
Objectives:
We describe a bilateral coronary leaflet modification technique that involves translocation of degenerated transcatheter valve leaflets before placement of valve-in-valve, named Bilateral Iatrogenic Coronary Obstruction Risk Nullification (BICORN).
Key Steps:
Key steps include the following: 1) Electrified 0.014-in ASTATO wires were traversed through the base of the right and left coronary leaflets of preexisting CoreValve, which were then swapped with 0.035-in wires; 2) Using peripheral balloons, leaflet traversal points were appropriately dilated; 3) A 26-mm Sapien valve was then advanced over the wire through the left coronary leaflet to the ascending aorta in a deployment-ready state; and 4) Right coronary leaflet was then translocated with 18-mm True balloon followed by deployment of the Sapien valve lined up to sixth node of the CoreValve.
Potential Pitfalls:
Translocation of preexisting valve leaflets is an uncontrolled step and can potentially lead to distal embolization and or severe aortic valve insufficiency.
Take-Home Messages:
BICORN can be considered as an option for transcatheter aortic valve in transcatheter aortic valve replacement in patients with extreme surgical risk.
More Related Videos
14:14Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
08:42Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
