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Catheter Cardiovasc Interv. 2019 Jan 1;93(1):164-168. doi: 10.1002/ccd.27721. Epub 2018 Oct 8.

Bioprosthetic aortic valve leaflet disruption with high energy electrocautery to prevent coronary artery obstruction during valve-in-valve transcatheter aortic valve replacement.

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Knight Cardiovascular Institute, Division of Cardiology, Oregon Health & Science University, Portland, Oregon.
Knight Cardiovascular Institute, Division of Cardiothoracic Surgery, Oregon Health & Science University, Portland, Oregon.


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.


aortic stenosis; coronary artery obstruction; transcatheter aortic valve replacement; valve-in-valve


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