Key result
Concurrent transcaval access and BASILICA enable safe self-expanding TAVR deployment in a high-risk patient.
Why the study?
Managing severe symptomatic aortic valve stenosis in patients at high risk for left main coronary artery obstruction and with limited transfemoral access presents procedural challenges.
Does concurrent transcaval access and the BASILICA procedure allow safe TAVR deployment in a patient with severe AS, high risk of coronary obstruction, and severe peripheral artery disease?
Case Report (n=1)
Does concurrent transcaval access and the BASILICA procedure allow safe TAVR deployment in a patient with severe AS, high risk of coronary obstruction, and severe peripheral artery disease?
The combination of transcaval access and the BASILICA procedure offers a feasible approach for TAVR in complex patients with prohibitive iliofemoral anatomy and high coronary obstruction risk.
Answers are grounded in this paper and cite their sources.
May enable TAVR in select prohibitive-access cases; hypothesis-generating and requires prospective validation.
We present a novel approach for managing severe symptomatic aortic valve stenosis (AS), in a patient at high risk for left main coronary artery obstruction with transcatheter aortic valve implantation (TAVR) and also significant bilateral iliofemoral peripheral artery disease limiting traditional transfemoral access. The patient underwent TAVR using transcaval access, and subsequent left aortic leaflet laceration (BASILICA) to reduce the risk of coronary obstruction. A self-expanding TAVR valve was deployed safely with a good hemodynamic result.
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Brieger et al. (2024) conducted a case report in Severe symptomatic aortic valve stenosis (n=1). Transcaval access and BASILICA procedure for TAVR was evaluated on Valve deployment safety and hemodynamic result. Concurrent transcaval access and the BASILICA procedure enabled safe deployment of a self-expanding TAVR valve with good hemodynamic results in a high-risk patient.
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