Key result
Fusion imaging-guided BASILICA enables coronary perfusion during valve-in-valve TAVR in high-risk stentless bioprostheses.
Why the study?
Valve-in-valve TAVR in patients with a stentless bioprosthetic surgical aortic valve is challenging due to lack of surgical frame, radiographic markers, and increased risk of coronary artery obstruction.
Case Report
Fusion imaging-guided BASILICA offers a technique to prevent coronary artery obstruction during valve-in-valve TAVR in patients with stentless bioprostheses.
May aid procedural planning in high-risk TAVR; leaves open safety and efficacy in stentless bioprostheses.
Valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR) in patients with a stentless bioprosthetic surgical aortic valve is challenging because of lack of a surgical frame for anchor, absence of radiographic markers for positioning, and an increased risk of coronary artery obstruction (CAO).1 In such patients at high risk of CAO, bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction (BASILICA) provides an alternative to allow adequate coronary perfusion.
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Basman et al. (2022) conducted a case report in Stentless bioprosthetic surgical aortic valve requiring Valve-in-Valve TAVR at high risk of coronary artery obstruction. Fusion Imaging-Guided BASILICA was evaluated. Fusion imaging-guided BASILICA provides an alternative to allow adequate coronary perfusion during valve-in-valve TAVR in patients with a stentless bioprosthesis at high risk of coronary obstruction.
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