Advertisement
Canadian Journal of Cardiology

BASILICA Technique for Prevention of Coronary Artery Occlusion in High-Risk Native Transcatheter Aortic Valve Replacement

Published:February 16, 2022DOI:https://doi.org/10.1016/j.cjca.2022.02.011
      Transcatheter aortic valve replacement (TAVR) is a safe alternative strategy for patients with symptomatic aortic stenosis (AS); however, a potential life-threatening complication is coronary artery occlusion, with an incidence of 0.4% to 1.2% and mortality estimated at 10.4% (procedural) and 35.3% (30-day).
      • Akinseye O.A.
      • Jha S.K.
      • Ibebuogu U.N.
      Clinical outcomes of coronary occlusion following transcatheter aortic valve replacement: a systematic review.
      In 2018, the novel procedure of bioprosthetic aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction (BASILICA), was described,
      • Khan J.M.
      • Dvir D.
      • Greenbaum A.B.
      • et al.
      Transcatheter laceration of aortic leaflets to prevent coronary obstruction during transcatheter aortic valve replacement: concept to first-in-human.
      which allowed patients with high-risk aortic anatomy to undergo TAVR. The BASILICA procedure lacerates the associated coronary cusp of the aortic valve using an electrified guidewire, causing the cusp to splay during TAVR, allowing blood flow into the threatened coronary artery ostium.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Canadian Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Akinseye O.A.
        • Jha S.K.
        • Ibebuogu U.N.
        Clinical outcomes of coronary occlusion following transcatheter aortic valve replacement: a systematic review.
        Cardiovasc Revasc Med. 2018; 19: 229-236
        • Khan J.M.
        • Dvir D.
        • Greenbaum A.B.
        • et al.
        Transcatheter laceration of aortic leaflets to prevent coronary obstruction during transcatheter aortic valve replacement: concept to first-in-human.
        JACC Cardiovasc Interv. 2018; 11: 677-689
        • Komatsu I.
        • Mackensen G.B.
        • Aldea G.S.
        • Reisman M.
        • Dvir D.
        Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction. Part 2: how to perform BASILICA.
        EuroIntervention. 2019; 15: 55-66
        • Komatsu I.
        • Mackensen G.B.
        • Aldea G.S.
        • Reisman M.
        • Dvir D.
        Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction. Part 1: how to evaluate patients for BASILICA.
        EuroIntervention. 2019; 15: 47-54
        • Khan J.M.
        • Greenbaum A.B.
        • Babaliaros V.C.
        • et al.
        The BASILICA trial: prospective multicenter investigation of intentional leaflet laceration to prevent TAVR Coronary obstruction.
        JACC Cardiovasc Interv. 2019; 12: 1240-1252