Emergency TAVR with leaflet modification using the UNICORN technique was successfully performed in a 26-year-old man with severe congenital aortic stenosis in cardiogenic shock.
Case Report (n=1)
Can the UNICORN technique be used to prevent coronary obstruction during TAVR in a patient with native congenital aortic stenosis?
The UNICORN leaflet modification technique can be successfully used to prevent coronary obstruction during TAVR in patients with native congenital aortic stenosis.
BACKGROUND: Coronary artery obstruction is a rare but serious complication of transcatheter aortic valve replacement (TAVR). Undermining iatrogenic coronary obstruction with a radiofrequency needle (UNICORN) is a novel technique of intraleaflet TAVR valve deployment for mitigating this risk. There is limited experience in native aortic valve anatomy, particularly in congenital aortic stenosis. CASE SUMMARY: A 26-year-old man in cardiogenic shock secondary to severe congenital aortic stenosis was successfully treated with emergency TAVR, with leaflet modification using the UNICORN technique due to the high risk of coronary obstruction. DISCUSSION: UNICORN is a novel technique for preventing coronary obstruction in TAVR. Here we describe the first case of UNICORN in congenital aortic stenosis in cardiogenic shock at prohibitive surgical risk. TAKE-HOME MESSAGES: UNICORN can be used successfully in carefully selected native valves at risk of coronary obstruction during TAVR. Use of leaflet modification techniques such as UNICORN enables intervention in a broader cohort of patients unfit for surgery.
Sharma et al. (Fri,) conducted a case report in Severe congenital aortic stenosis in cardiogenic shock (n=1). Emergency TAVR with leaflet modification using the UNICORN technique was evaluated on Successful treatment and prevention of coronary obstruction. Emergency TAVR with leaflet modification using the UNICORN technique was successfully performed in a 26-year-old man with severe congenital aortic stenosis in cardiogenic shock.