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BASILICA Technique: Why, When and How?
Harminder S Gill1, Jaffar M Khan1
1Department of Cardiology, St Francis Hospital & Heart Center Roslyn, NY, US.
European Cardiology
|July 23, 2026
Summary
The Bioprosthetic or Native Aortic Scallop Intentional Laceration to Prevent Iatrogenic Coronary Artery Obstruction (BASILICA) procedure prevents coronary artery obstruction after transcatheter aortic valve replacement by lacerating valve leaflets. This ensures continued blood flow to the coronary arteries.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Biomedical Engineering
Background:
- Coronary artery obstruction is a life-threatening complication post-transcatheter aortic valve replacement.
- Obstruction occurs due to valve leaflet displacement or coronary sinus sequestration.
- Existing methods lack sufficient preventative measures.
Purpose of the Study:
- To review the Bioprosthetic or Native Aortic Scallop Intentional Laceration to Prevent Iatrogenic Coronary Artery Obstruction (BASILICA) procedure.
- To detail the methodology, patient selection, and procedural steps of BASILICA.
- To discuss challenges and solutions for BASILICA operators.
Main Methods:
- Patient selection based on anatomical and imaging parameters.
- Utilizing catheter electrosurgery for leaflet puncture and laceration.
- Systematic description of BASILICA procedural steps: access, traversal, puncture, laceration, and completion.
Main Results:
- The BASILICA procedure effectively mitigates the risk of coronary artery obstruction.
- Successful implantation of transcatheter heart valves while maintaining coronary perfusion.
- Demonstrated feasibility and technique for maintaining coronary blood flow.
Conclusions:
- BASILICA is a crucial technique for preventing coronary artery obstruction during TAVR.
- Careful patient selection and procedural execution are key to success.
- The review provides a comprehensive guide for operators performing the BASILICA procedure.
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