Key result
Coronary occlusion during TAVR valve-in-valve procedures is a rare but highly fatal complication that can be mitigated through meticulous pre-procedural planning and techniques like BASILICA.
Why the study?
Coronary occlusion during transcatheter aortic valve-in-valve replacement is a feared, rare complication associated with an extremely poor prognosis.
Meticulous pre-procedural planning and the use of novel techniques such as BASILICA or the Chimney technique are essential to prevent fatal coronary occlusion during TAVR valve-in-valve procedures in high-risk patients.
High mortality from coronary occlusion in TAVR warrants vigilant CT planning; leaves open comparative efficacy of preventive techniques.
Transcatheter aortic valve-in-valve replacement has been recently reported as a less-invasive alternative to re-do surgery in patients with bioprosthetic valve failure. Although procedural success is achieved in the great majority of patients, this therapy is associated with several potential complications, and coronary occlusion is one of the most feared. This is a rare event, but it is associated with an extremely poor prognosis. In this review, the mechanisms, the identification of patients at high risk, the primary prevention strategies, and treatment of coronary occlusion will be discussed.
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Valvo et al. (2019) conducted a review in Bioprosthetic valve failure requiring TAVR Valve-in-Valve. Coronary protection techniques (e.g., BASILICA, Chimney technique) was evaluated. Coronary occlusion during TAVR valve-in-valve procedures is a rare but highly fatal complication that can be mitigated through meticulous pre-procedural planning and techniques like BASILICA.
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