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Danny Dvir - One of the best experts on this subject based on the ideXlab platform.
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echocardiographic guidance of intentional leaflet laceration prior to transcatheter aortic valve replacement a structured approach to the bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction procedure
2021Co-Authors: Volodymyr Protsyk, Burkhard G Mackensen, Danny Dvir, Massimiliano Meineri, Mitsunobu Kitamura, Anna Flo Forner, David Holzhey, Holger Thiele, Mohamed Abdelwahab, Joerg EnderAbstract:Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction (BASILICA) is a recently developed technique to reduce the risk of ostial Coronary Obstruction during transcatheter aortic valve replacement. Intraprocedural fluoroscopy and transesophageal echocardiography imaging are used complimentarily to guide the procedure. So far, no structured echocardiographic imaging protocol has been described for this intervention. Based on an experience of more than 50 BASILICA procedures at two different institutions, we present a step-by-step approach for transesophageal echocardiography guidance during BASILICA and highlight anatomical and procedural characteristics from an echocardiographic perspective.
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echocardiographic guidance of intentional leaflet laceration prior to transcatheter aortic valve replacement a structured approach to the bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction procedure
2021Co-Authors: Volodymyr Protsyk, Burkhard G Mackensen, Danny Dvir, Massimiliano Meineri, Mitsunobu Kitamura, Anna Flo Forner, David Holzhey, Holger Thiele, Mohamed Abdelwahab, Joerg EnderAbstract:Abstract Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction (BASILICA) is a recently developed technique to reduce the risk of ostial Coronary Obstruction during transcatheter aortic valve replacement (TAVR). Intraprocedural fluoroscopy and transesophageal echocardiography (TEE) imaging are used complimentarily to guide the procedure. So far, no structured echocardiographic imaging protocol has been described for this intervention. Based on an experience of more than 50 BASILICA procedures at two different institutions, we present a step-by-step approach for TEE-guidance during BASILICA and highlight anatomical and procedural characteristics from an echocardiographic perspective.
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echocardiographic guidance of intentional leaflet laceration prior to transcatheter aortic valve replacement a structured approach to the basilica procedure
2021Co-Authors: Volodymyr Protsyk, Burkhard G Mackensen, Danny Dvir, Massimiliano Meineri, Mitsunobu Kitamura, Anna Flo Forner, David Holzhey, Holger Thiele, Mohamed Abdelwahab, Joerg EnderAbstract:Abstract Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction (BASILICA) is a recently developed technique to reduce the risk of ostial Coronary Obstruction during transcatheter aortic valve replacement (TAVR). Intraprocedural fluoroscopy and transesophageal echocardiography (TEE) imaging are used complimentarily to guide the procedure. So far, no structured echocardiographic imaging protocol has been described for this intervention. Based on an experience of more than 50 BASILICA procedures at two different institutions, we present a step-by-step approach for TEE-guidance during BASILICA and highlight anatomical and procedural characteristics from an echocardiographic perspective.
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Coronary Artery Obstruction risk with redo tavr a word of caution
2020Co-Authors: Ikki Komatsu, Danny Dvir, Gilbert H L TangAbstract:We read the paper by Landes et al. ([1][1]), which described outcomes of repeated transcatheter aortic valve replacement (TAVR) procedures, with great interest. The authors should be congratulated for their important contribution. As TAVR expands toward younger patients, the feasibility of redoing
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bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction part 1 how to evaluate patients for basilica
2019Co-Authors: Ikki Komatsu, Burkhard G Mackensen, Gabriel S Aldea, Mark Reisman, Danny DvirAbstract:Coronary Obstruction is a life-threatening complication of transcatheter aortic valve replacement. BASILICA (bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction) seems to be an effective method for preventing that complication. In this article, we describe how to assess patients for their risk of Coronary Obstruction and how to evaluate for BASILICA, including defining Coronary cusp fluoroscopic projections and analysing Coronary ostia eccentricity.
Burkhard G Mackensen - One of the best experts on this subject based on the ideXlab platform.
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echocardiographic guidance of intentional leaflet laceration prior to transcatheter aortic valve replacement a structured approach to the bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction procedure
2021Co-Authors: Volodymyr Protsyk, Burkhard G Mackensen, Danny Dvir, Massimiliano Meineri, Mitsunobu Kitamura, Anna Flo Forner, David Holzhey, Holger Thiele, Mohamed Abdelwahab, Joerg EnderAbstract:Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction (BASILICA) is a recently developed technique to reduce the risk of ostial Coronary Obstruction during transcatheter aortic valve replacement. Intraprocedural fluoroscopy and transesophageal echocardiography imaging are used complimentarily to guide the procedure. So far, no structured echocardiographic imaging protocol has been described for this intervention. Based on an experience of more than 50 BASILICA procedures at two different institutions, we present a step-by-step approach for transesophageal echocardiography guidance during BASILICA and highlight anatomical and procedural characteristics from an echocardiographic perspective.
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echocardiographic guidance of intentional leaflet laceration prior to transcatheter aortic valve replacement a structured approach to the bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction procedure
2021Co-Authors: Volodymyr Protsyk, Burkhard G Mackensen, Danny Dvir, Massimiliano Meineri, Mitsunobu Kitamura, Anna Flo Forner, David Holzhey, Holger Thiele, Mohamed Abdelwahab, Joerg EnderAbstract:Abstract Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction (BASILICA) is a recently developed technique to reduce the risk of ostial Coronary Obstruction during transcatheter aortic valve replacement (TAVR). Intraprocedural fluoroscopy and transesophageal echocardiography (TEE) imaging are used complimentarily to guide the procedure. So far, no structured echocardiographic imaging protocol has been described for this intervention. Based on an experience of more than 50 BASILICA procedures at two different institutions, we present a step-by-step approach for TEE-guidance during BASILICA and highlight anatomical and procedural characteristics from an echocardiographic perspective.
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echocardiographic guidance of intentional leaflet laceration prior to transcatheter aortic valve replacement a structured approach to the basilica procedure
2021Co-Authors: Volodymyr Protsyk, Burkhard G Mackensen, Danny Dvir, Massimiliano Meineri, Mitsunobu Kitamura, Anna Flo Forner, David Holzhey, Holger Thiele, Mohamed Abdelwahab, Joerg EnderAbstract:Abstract Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction (BASILICA) is a recently developed technique to reduce the risk of ostial Coronary Obstruction during transcatheter aortic valve replacement (TAVR). Intraprocedural fluoroscopy and transesophageal echocardiography (TEE) imaging are used complimentarily to guide the procedure. So far, no structured echocardiographic imaging protocol has been described for this intervention. Based on an experience of more than 50 BASILICA procedures at two different institutions, we present a step-by-step approach for TEE-guidance during BASILICA and highlight anatomical and procedural characteristics from an echocardiographic perspective.
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technical considerations and pitfalls of basilica bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction
2020Co-Authors: Ikki Komatsu, Burkhard G Mackensen, Mark Reisman, Harindra Wijeysandera, Sam Radharkrisnan, Brian Whisenant, Matheus Simonato, Albert Chen, Christian Spies, Kashish GoelAbstract:Coronary Obstruction is a major complication of transcatheter aortic valve replacement (TAVR). Rapid and growing demand for TAVR procedures is accompanied by interest in techniques that may prevent...
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Coronary ostial eccentricity in severe aortic stenosis guidance for basilica transcatheter leaflet laceration
2020Co-Authors: Ikki Komatsu, Jonathon Leipsic, John G Webb, Philipp Blanke, Burkhard G Mackensen, James M Mccabe, Christopher Rumer, Creighton W Don, Christina W Tan, Dmitry LevinAbstract:Abstract Background Eccentricity of Coronary ostial positions in relation to the aortic valve cusp may influence the target laceration location in BASILICA (Bioprosthetic or native Aortic Scallop Intentional Laceration to prevent Coronary Artery Obstruction). Eccentricity of the Coronary ostia in relation to Coronary cusps of native and valve-in-valve transcatheter aortic valve replacement (TAVR) was not well described before. Methods A total of 121 pre-TAVR patients’ CT data (72 native valves TAVR and 49 bioprosthetic surgical valves TAVR) was included and Coronary ostial eccentricity angles were measured and compared. Coronary ostial angles were measured between mid-cusp line to Coronary ostium in CT perpendicular images. Results In the overall cohort, the right Coronary Artery (RCA) had an eccentric origin in the majority of cases, favoring the commissure between the right and the non Coronary cusp (17.0°, IQR; 10–25). On the other hand, the left Coronary Artery (LCA) originated most commonly near center of the cusp position (0°, IQR; -8 -7.5) In comparison of native and bioprosthetic valves, RCA ostial angles were more eccentric in native valves (19.0°, IQR; 12–26) than in bioprosthetic valves (14.0°, IQR; 3–20) (p = 0.004). Whereas, LCA ostial angle has no significant differences between native valves (−2.0°, IQR;-7.75-5.75) and bioprosthetic valves (1°, IQR;-8-13), (p = 0.6). Conclusion RCA ostia often have an eccentric origin towards the non-Coronary cusp, especially in native aortic valves, while LCA ostia commonly originate near the center of the cusp. This finding may contribute to better performance of BASILICA procedures.
Ikki Komatsu - One of the best experts on this subject based on the ideXlab platform.
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Coronary Artery Obstruction risk with redo tavr a word of caution
2020Co-Authors: Ikki Komatsu, Danny Dvir, Gilbert H L TangAbstract:We read the paper by Landes et al. ([1][1]), which described outcomes of repeated transcatheter aortic valve replacement (TAVR) procedures, with great interest. The authors should be congratulated for their important contribution. As TAVR expands toward younger patients, the feasibility of redoing
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technical considerations and pitfalls of basilica bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction
2020Co-Authors: Ikki Komatsu, Burkhard G Mackensen, Mark Reisman, Harindra Wijeysandera, Sam Radharkrisnan, Brian Whisenant, Matheus Simonato, Albert Chen, Christian Spies, Kashish GoelAbstract:Coronary Obstruction is a major complication of transcatheter aortic valve replacement (TAVR). Rapid and growing demand for TAVR procedures is accompanied by interest in techniques that may prevent...
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Coronary ostial eccentricity in severe aortic stenosis guidance for basilica transcatheter leaflet laceration
2020Co-Authors: Ikki Komatsu, Jonathon Leipsic, John G Webb, Philipp Blanke, Burkhard G Mackensen, James M Mccabe, Christopher Rumer, Creighton W Don, Christina W Tan, Dmitry LevinAbstract:Abstract Background Eccentricity of Coronary ostial positions in relation to the aortic valve cusp may influence the target laceration location in BASILICA (Bioprosthetic or native Aortic Scallop Intentional Laceration to prevent Coronary Artery Obstruction). Eccentricity of the Coronary ostia in relation to Coronary cusps of native and valve-in-valve transcatheter aortic valve replacement (TAVR) was not well described before. Methods A total of 121 pre-TAVR patients’ CT data (72 native valves TAVR and 49 bioprosthetic surgical valves TAVR) was included and Coronary ostial eccentricity angles were measured and compared. Coronary ostial angles were measured between mid-cusp line to Coronary ostium in CT perpendicular images. Results In the overall cohort, the right Coronary Artery (RCA) had an eccentric origin in the majority of cases, favoring the commissure between the right and the non Coronary cusp (17.0°, IQR; 10–25). On the other hand, the left Coronary Artery (LCA) originated most commonly near center of the cusp position (0°, IQR; -8 -7.5) In comparison of native and bioprosthetic valves, RCA ostial angles were more eccentric in native valves (19.0°, IQR; 12–26) than in bioprosthetic valves (14.0°, IQR; 3–20) (p = 0.004). Whereas, LCA ostial angle has no significant differences between native valves (−2.0°, IQR;-7.75-5.75) and bioprosthetic valves (1°, IQR;-8-13), (p = 0.6). Conclusion RCA ostia often have an eccentric origin towards the non-Coronary cusp, especially in native aortic valves, while LCA ostia commonly originate near the center of the cusp. This finding may contribute to better performance of BASILICA procedures.
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Coronary ostial eccentricity in severe aortic stenosis guidance for basilica transcatheter leaflet laceration
2020Co-Authors: Ikki Komatsu, Jonathon Leipsic, John G Webb, Philipp Blanke, Burkhard G Mackensen, James M Mccabe, Christopher Rumer, Dmitry Levin, Mario Ramos, Gabriel S AldeaAbstract:Abstract Background Eccentricity of Coronary ostial positions in relation to the aortic valve cusp may influence the target laceration location in BASILICA (Bioprosthetic or native Aortic Scallop Intentional Laceration to prevent Coronary Artery Obstruction). Eccentricity of the Coronary ostia in relation to Coronary cusps of native and valve-in-valve transcatheter aortic valve replacement (TAVR) was not well described before. Methods A total of 121 pre-TAVR patients’ CT data (72 native valves TAVR and 49 bioprosthetic surgical valves TAVR) was included and Coronary ostial eccentricity angles were measured and compared. Coronary ostial angles were measured between mid-cusp line to Coronary ostium in CT perpendicular images. Results In the overall cohort, the right Coronary Artery (RCA) had an eccentric origin in the majority of cases, favoring the commissure between the right and the non Coronary cusp (17.0°, IQR; 10–25). On the other hand, the left Coronary Artery (LCA) originated most commonly near center of the cusp position (0°, IQR; -8 -7.5) In comparison of native and bioprosthetic valves, RCA ostial angles were more eccentric in native valves (19.0°, IQR; 12–26) than in bioprosthetic valves (14.0°, IQR; 3–20) (p = 0.004). Whereas, LCA ostial angle has no significant differences between native valves (−2.0°, IQR;-7.75-5.75) and bioprosthetic valves (1°, IQR;-8-13), (p = 0.6). Conclusion RCA ostia often have an eccentric origin towards the non-Coronary cusp, especially in native aortic valves, while LCA ostia commonly originate near the center of the cusp. This finding may contribute to better performance of BASILICA procedures.
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imaging of aortic valve cusps using commissural alignment guidance for transcatheter leaflet laceration with basilica
2019Co-Authors: Ikki Komatsu, Jonathon Leipsic, Philipp Blanke, Burkhard G Mackensen, James M Mccabe, Christopher Rumer, John B Webb, Creighton W Don, Christina W Tan, Dmitry LevinAbstract:Coronary Artery Obstruction is a potentially fatal complication of transcatheter aortic valve replacement; hence pre-procedural risk evaluation and proper planning are crucial [(1)][1]. Bioprosthetic or native aortic scallop intentional laceration to prevent Coronary Artery Obstruction (BASILICA) is
Gabriel S Aldea - One of the best experts on this subject based on the ideXlab platform.
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Coronary ostial eccentricity in severe aortic stenosis guidance for basilica transcatheter leaflet laceration
2020Co-Authors: Ikki Komatsu, Jonathon Leipsic, John G Webb, Philipp Blanke, Burkhard G Mackensen, James M Mccabe, Christopher Rumer, Dmitry Levin, Mario Ramos, Gabriel S AldeaAbstract:Abstract Background Eccentricity of Coronary ostial positions in relation to the aortic valve cusp may influence the target laceration location in BASILICA (Bioprosthetic or native Aortic Scallop Intentional Laceration to prevent Coronary Artery Obstruction). Eccentricity of the Coronary ostia in relation to Coronary cusps of native and valve-in-valve transcatheter aortic valve replacement (TAVR) was not well described before. Methods A total of 121 pre-TAVR patients’ CT data (72 native valves TAVR and 49 bioprosthetic surgical valves TAVR) was included and Coronary ostial eccentricity angles were measured and compared. Coronary ostial angles were measured between mid-cusp line to Coronary ostium in CT perpendicular images. Results In the overall cohort, the right Coronary Artery (RCA) had an eccentric origin in the majority of cases, favoring the commissure between the right and the non Coronary cusp (17.0°, IQR; 10–25). On the other hand, the left Coronary Artery (LCA) originated most commonly near center of the cusp position (0°, IQR; -8 -7.5) In comparison of native and bioprosthetic valves, RCA ostial angles were more eccentric in native valves (19.0°, IQR; 12–26) than in bioprosthetic valves (14.0°, IQR; 3–20) (p = 0.004). Whereas, LCA ostial angle has no significant differences between native valves (−2.0°, IQR;-7.75-5.75) and bioprosthetic valves (1°, IQR;-8-13), (p = 0.6). Conclusion RCA ostia often have an eccentric origin towards the non-Coronary cusp, especially in native aortic valves, while LCA ostia commonly originate near the center of the cusp. This finding may contribute to better performance of BASILICA procedures.
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bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction part 1 how to evaluate patients for basilica
2019Co-Authors: Ikki Komatsu, Burkhard G Mackensen, Gabriel S Aldea, Mark Reisman, Danny DvirAbstract:Coronary Obstruction is a life-threatening complication of transcatheter aortic valve replacement. BASILICA (bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction) seems to be an effective method for preventing that complication. In this article, we describe how to assess patients for their risk of Coronary Obstruction and how to evaluate for BASILICA, including defining Coronary cusp fluoroscopic projections and analysing Coronary ostia eccentricity.
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bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction part 2 how to perform basilica
2019Co-Authors: Ikki Komatsu, Burkhard G Mackensen, Gabriel S Aldea, Mark Reisman, Danny DvirAbstract:Coronary Obstruction is a life-threatening complication of transcatheter aortic valve replacement. Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction (BASILICA) seems to be an effective approach for preventing Coronary Obstruction by maintaining blood flow towards the Coronary Artery by an intentionally created leaflet laceration. In this report, we aimed to provide step-by-step guidance on how to perform a BASILICA procedure. The technique includes several steps that can be challenging without proper guidance. Assistance by operators who have already performed BASILICA seems to be crucial, and formal proctorship during initial procedures can ensure good clinical outcomes.
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transcatheter laceration of aortic leaflets to prevent Coronary Obstruction during transcatheter aortic valve replacement concept to first in human
2018Co-Authors: Jaffar M Khan, Burkhard G Mackensen, Gabriel S Aldea, Adam Greenbaum, Vasilis C Babaliaros, Toby Rogers, Marvin H Eng, Mark Reisman, Danny Dvir, Gaetano PaoneAbstract:AbstractObjectives: This study sought to develop a novel technique called bioprosthetic or native aortic scallop intentional laceration to prevent Coronary Artery Obstruction (BASILICA).Background:...
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transcatheter laceration of aortic leaflets to prevent Coronary Obstruction during transcatheter aortic valve replacement concept to first in human
2018Co-Authors: Jaffar M Khan, Burkhard G Mackensen, Gabriel S Aldea, Adam Greenbaum, Vasilis C Babaliaros, Toby Rogers, Marvin H Eng, Mark Reisman, Danny Dvir, Gaetano PaoneAbstract:Abstract Objectives This study sought to develop a novel technique called bioprosthetic or native aortic scallop intentional laceration to prevent Coronary Artery Obstruction (BASILICA). Background Coronary Artery Obstruction is a rare but fatal complication of transcatheter aortic valve replacement (TAVR). Methods We lacerated pericardial leaflets in vitro using catheter electrosurgery, and tested leaflet splaying after benchtop TAVR. The procedure was tested in swine. BASILICA was then offered to patients at high risk of Coronary Obstruction from TAVR and ineligible for surgical aortic valve replacement. BASILICA used marketed devices. Catheters directed an electrified guidewire to traverse and lacerate the aortic leaflet down the center line. TAVR was performed as usual. Results TAVR splayed lacerated bovine pericardial leaflets. BASILICA was successful in pigs, both to left and right cusps. Necropsy revealed full length lacerations with no collateral thermal injury. Seven patients underwent BASILICA on a compassionate basis. Six had failed bioprosthetic valves, both stented and stent-less. Two had severe aortic stenosis, including 1 patient with native disease, 3 had severe aortic regurgitation, and 2 had mixed aortic valve disease. One patient required laceration of both left and right Coronary cusps. There was no hemodynamic compromise in any patient following BASILICA. All patients had successful TAVR, with no Coronary Obstruction, stroke, or any major complications. All patients survived to 30 days. Conclusions BASILICA may durably prevent Coronary Obstruction from TAVR. The procedure was successful across a range of presentations, and requires further evaluation in a prospective trial. Its role in treatment of degenerated TAVR devices remains untested.
Mark Reisman - One of the best experts on this subject based on the ideXlab platform.
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technical considerations and pitfalls of basilica bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction
2020Co-Authors: Ikki Komatsu, Burkhard G Mackensen, Mark Reisman, Harindra Wijeysandera, Sam Radharkrisnan, Brian Whisenant, Matheus Simonato, Albert Chen, Christian Spies, Kashish GoelAbstract:Coronary Obstruction is a major complication of transcatheter aortic valve replacement (TAVR). Rapid and growing demand for TAVR procedures is accompanied by interest in techniques that may prevent...
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the basilica trial prospective multicenter investigation of intentional leaflet laceration to prevent tavr Coronary Obstruction
2019Co-Authors: Jaffar M Khan, Adam Greenbaum, Vasilis C Babaliaros, Toby Rogers, Marvin H Eng, Gaetano Paone, Bradley G Leshnower, Mark Reisman, Lowell F Satler, Ron WaksmanAbstract:Abstract Objectives The BASILICA (Bioprosthetic or native Aortic Scallop Intentional Laceration to prevent Iatrogenic Coronary Artery Obstruction during TAVR) investigational device exemption trial was a prospective, multicenter, single-arm safety and feasibility study. Background Coronary Artery Obstruction is a rare but devastating complication of transcatheter aortic valve replacement (TAVR). Current stent-based preventative strategies are suboptimal. Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction during TAVR (BASILICA) is a novel transcatheter technique performed immediately before TAVR to prevent Coronary Artery Obstruction. Methods Subjects with severe native or bioprosthetic aortic valve disease at high or extreme risk for surgery, and at high risk of Coronary Artery Obstruction, were included. The primary success endpoint was successful BASILICA and TAVR without Coronary Obstruction or reintervention. The primary safety endpoint was freedom from major adverse cardiovascular events. Data were independently monitored. Endpoints were independently adjudicated. A core laboratory analyzed computed tomography images. Results Between February 2018 and July 2018, 30 subjects were enrolled. Primary success was met in 28 (93%) subjects. BASILICA traversal and laceration was successful in 35 of 37 (95%) attempted leaflets. There was 100% freedom from Coronary Obstruction and reintervention. Primary safety was met in 21 (70%), driven by 6 (20%) major vascular complications related to TAVR but not BASILICA. There was 1 death at 30 days. There was 1 (3%) disabling stroke and 2 (7%) nondisabling strokes. Transient hemodynamic compromise was rare (7%) and resolved promptly with TAVR. Conclusions BASILICA was feasible in both native and bioprosthetic valves. Hemodynamic compromise was uncommon. Safety was acceptable and needs confirmation in larger studies. BASILICA appears effective in preventing Coronary Artery Obstruction from TAVR in subjects at high risk.
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bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction part 1 how to evaluate patients for basilica
2019Co-Authors: Ikki Komatsu, Burkhard G Mackensen, Gabriel S Aldea, Mark Reisman, Danny DvirAbstract:Coronary Obstruction is a life-threatening complication of transcatheter aortic valve replacement. BASILICA (bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction) seems to be an effective method for preventing that complication. In this article, we describe how to assess patients for their risk of Coronary Obstruction and how to evaluate for BASILICA, including defining Coronary cusp fluoroscopic projections and analysing Coronary ostia eccentricity.
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bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction part 2 how to perform basilica
2019Co-Authors: Ikki Komatsu, Burkhard G Mackensen, Gabriel S Aldea, Mark Reisman, Danny DvirAbstract:Coronary Obstruction is a life-threatening complication of transcatheter aortic valve replacement. Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic Coronary Artery Obstruction (BASILICA) seems to be an effective approach for preventing Coronary Obstruction by maintaining blood flow towards the Coronary Artery by an intentionally created leaflet laceration. In this report, we aimed to provide step-by-step guidance on how to perform a BASILICA procedure. The technique includes several steps that can be challenging without proper guidance. Assistance by operators who have already performed BASILICA seems to be crucial, and formal proctorship during initial procedures can ensure good clinical outcomes.
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transcatheter laceration of aortic leaflets to prevent Coronary Obstruction during transcatheter aortic valve replacement concept to first in human
2018Co-Authors: Jaffar M Khan, Burkhard G Mackensen, Gabriel S Aldea, Adam Greenbaum, Vasilis C Babaliaros, Toby Rogers, Marvin H Eng, Mark Reisman, Danny Dvir, Gaetano PaoneAbstract:AbstractObjectives: This study sought to develop a novel technique called bioprosthetic or native aortic scallop intentional laceration to prevent Coronary Artery Obstruction (BASILICA).Background:...