Key result
Chimney stenting and BASILICA offer effective strategies to prevent coronary obstruction during ViV-TAVR.
Why the study?
VIV-TAVR carries an increased risk of coronary artery obstruction, and guidance is needed on the indications, contraindications, and relative merits of chimney stenting versus leaflet modification.
Case Report (n=1)
Answers are grounded in this paper and cite their sources.
Chimney stenting and BASILICA are both viable strategies to prevent coronary artery obstruction during valve-in-valve TAVR, with specific indications and merits discussed.
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.
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Montarello et al. (2023) conducted a case report in Degenerated surgical aortic bioprosthesis at risk for coronary artery obstruction during VIV-TAVR (n=1). Chimney stenting and leaflet modification (BASILICA) was evaluated. Chimney stenting and leaflet modification by BASILICA are both discussed as effective techniques to prevent coronary artery obstruction during valve-in-valve transcatheter aortic valve replacement.
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