Intentional transcatheter laceration of the coronary cusp to prevent left main stem obstruction during transcatheter aortic valve implantation: first European experience with the BASILICA technique in a native aortic valve

摘要

Severe coronary obstruction during transcatheter aortic valve implantation (TAVI) most commonly occurs with shallow aortic sinuses due to lateral displacement of pre-existing native aortic/bioprosthetic valve leaflets and occlusion of a low-lying coronary ostium ( ). Coronary wire and/or stent placement may enable bailout management; however, reliable preventative strategies are limited. Intentional aortic scallop laceration to prevent coronary artery obstruction (BASILICA) is a novel transcatheter technique that may reduce this complication. Two BASILICA patients were treated at our institution: one bioprosthetic valve, and the 2nd native leaflet case performed worldwide (described below).