Bioprosthetic aortic valve leaflet disruption with high energy electrocautery to prevent coronary artery obstruction during valve-in-valve transcatheter aortic valve replacement.
Bradley C NelsonScott ChadderdonHoward SongFiras E ZahrPublished in: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2018)
Transcatheter aortic valve replacement (TAVR) is well-established for the treatment of bioprosthetic aortic valve stenosis (AS) in high surgical risk patients. Coronary artery obstruction from displacement of the bioprosthetic valve leaflets during valve-in-valve (VIV) TAVR is a rare, but potentially fatal, complication. Recently, the bioprosthetic aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction (BASILICA) procedure was developed as a method for disrupting bioprosthetic leaflets in patients undergoing VIV TAVR at high risk for coronary obstruction. This case describes a successful VIV TAVR utilizing a simplified concept of the BASILICA technique in a patient where the full procedure could not be completed.
Keyphrases
- aortic valve
- transcatheter aortic valve replacement
- coronary artery
- aortic stenosis
- aortic valve replacement
- transcatheter aortic valve implantation
- pulmonary artery
- patients undergoing
- end stage renal disease
- ejection fraction
- minimally invasive
- chronic kidney disease
- coronary artery disease
- newly diagnosed
- mitral valve
- patient reported outcomes
- pulmonary arterial hypertension
- prognostic factors
- case report