Leaflet modification or chimney stenting in patients at risk for coronary artery obstruction in valve‐in‐valve procedure for a failed surgical bioprosthetic aortic valve. Issue 3 (18th January 2023)

• Record Type: Journal Article
• Authors: Montarello, Nicholas J.; Quagliana, Angelo; Søndergaard, Lars; De Backer, Ole
• Is Part Of: Catheterization and cardiovascular interventions. Volume 101:Issue 3(2023)
• Page Start: 655
• Page End: 659
• Publication Date: 2023-01-18
• Subjects: BASILICA -- chimney stenting -- coronary obstruction -- transcatheter aortic valve replacement -- valve‐in‐valve; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.30561
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: 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.