Leaflet modification or chimney stenting in patients at risk for coronary artery obstruction in valve-in-valve procedure for a failed surgical bioprosthetic aortic valve.
Nicholas J MontarelloAngelo QuaglianaLars SøndergaardOle De BackerPublished in: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2023)
Valve-in-valve transcatheter aortic valve replacement (VIV-TAVR) for a degenerated surgical aortic bioprosthesis is a well-established treatment modality but carries an increased risk of coronary artery obstruction (CAO) with potentially catastrophic consequences. Both chimney stenting and leaflet modification by BASILICA (Bioprosthetic or Native Aortic Scallop Intentional Laceration to Prevent Iatrogenic Coronary Obstruction) are increasingly employed and can be highly effective means of preventing CAO. Using a case report, in which both strategies were utilized, as a platform for detailed discussion, we address the indications, contraindications, and relative merits of each technique in the prevention of CAO.
Keyphrases
- aortic valve
- transcatheter aortic valve replacement
- coronary artery
- aortic stenosis
- aortic valve replacement
- transcatheter aortic valve implantation
- pulmonary artery
- end stage renal disease
- ejection fraction
- prognostic factors
- antiplatelet therapy
- newly diagnosed
- chronic kidney disease
- coronary artery disease
- peritoneal dialysis
- mitral valve
- minimally invasive
- left ventricular
- combination therapy
- pulmonary hypertension