Aortic valve leaflet disruption techniques in transcatheter aortic valve replacement

Brian Shin; David Li; Hong LIU

doi:10.11909/j.issn.1671-5411.2022.12.006

Volume 19 Issue 12

Dec. 2022

Turn off MathJax

Article Contents

Article Navigation > Journal of Geriatric Cardiology > 2022 > 19(12): 990-994

Please cite this article as: Shin B, Li D, LIU H. Aortic valve leaflet disruption techniques in transcatheter aortic valve replacement. J Geriatr Cardiol 2022; 19(12): 990−994. DOI: 10.11909/j.issn.1671-5411.2022.12.006

Citation:

Please cite this article as: Shin B, Li D, LIU H. Aortic valve leaflet disruption techniques in transcatheter aortic valve replacement. J Geriatr Cardiol 2022; 19(12): 990−994. DOI: 10.11909/j.issn.1671-5411.2022.12.006

Citation:

PDF( 5690 KB)

Aortic valve leaflet disruption techniques in transcatheter aortic valve replacement

doi: 10.11909/j.issn.1671-5411.2022.12.006

1.
Department of Anesthesiology and Pain Medicine, University of California Davis Health, Sacramento, USA

More Information

Corresponding author: dpli@ucdavis.edu; hualiu@ucdavis.edu
Publish Date: 2022-12-28

Abstract

Abstract

With continued technological advancement and technical improvement of transcatheter aortic valve replacement (TAVR), it has become a desirable treatment option for aortic valve stenosis. Its minimally invasive approach compared to surgical aortic valve replacement offers the treatment to a broader patient population, mainly non-surgical candidates. A feared complication of TAVR is the occlusion of coronary artery ostium by the native aortic valve leaflet due to its displacement by the expanded transcatheter valve. Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction (BASILICA) is a technique developed to mitigate this risk by creating a lengthwise laceration of the left and/or right aortic valve leaflets prior to TAVR. Patient outcomes following TAVR with BASILICA have been promising. Meticulous preoperative examination, patient selection, and hemodynamic management are imperative. With continued refinement, BASILICA may further expand the application of TAVR to patients at high risk for coronary occlusion associated with the procedure.

FullText(HTML)

References(18)

References

[1]	Cerrato E, Nombela-Franco L, Nazif TM, et al. Evaluation of current practices in transcatheter aortic valve implantation: the WRITTEN (WoRldwIde TAVI ExperieNce) survey. Int J Cardiol 2017; 228: 640−647. doi: 10.1016/j.ijcard.2016.11.104
[2]	Smith CR, Leon MB, Mack MJ, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med 2011; 364: 2187−2198. doi: 10.1056/NEJMoa1103510
[3]	Leon MB, Smith CR, Mack MJ, et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med 2016; 374: 1609−1620. doi: 10.1056/NEJMoa1514616
[4]	Mack MJ, Leon MB, Thourani VH, et al. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med 2019; 380: 1695−1705. doi: 10.1056/NEJMoa1814052
[5]	Bonow RO, Brown AS, Gillam LD, et al. ACC/AATS/AHA/ASE/EACTS/HVS/SCA/SCAI/SCCT/SCMR/STS 2017 appropriate use criteria for the treatment of patients with severe aortic stenosis: a report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, European Association for Cardio-Thoracic Surgery, Heart Valve Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. J Am Coll Cardiol 2017; 70: 2566−2598. doi: 10.1016/j.jacc.2017.09.018
[6]	Valvo R, Costa G, Barbanti M. How to avoid coronary occlusion during TAVR valve-in-valve procedures. Front Cardiovasc Med 2019; 6: 168. doi: 10.3389/fcvm.2019.00168
[7]	Vandvik PO, Otto CM, Siemieniuk RA, et al. Transcatheter or surgical aortic valve replacement for patients with severe, symptomatic, aortic stenosis at low to intermediate surgical risk: a clinical practice guideline. BMJ 2016; 354: i5085. doi: 10.1136/bmj.i5085
[8]	Ribeiro HB, Sarmento-Leite R, Siqueira DA, et al. Coronary obstruction following transcatheter aortic valve implantation. Arq Bras Cardiol 2014; 102: 93−96. doi: 10.5935/abc.20130252
[9]	Kukucka M, Pasic M, Dreysse S, et al. Delayed subtotal coronary obstruction after transapical aortic valve implantation. Interact Cardiovasc Thorac Surg 2011; 12: 57−60. doi: 10.1510/icvts.2010.252866
[10]	Ribeiro HB, Webb JG, Makkar RR, et al. Predictive factors, management, and clinical outcomes of coronary obstruction following transcatheter aortic valve implantation: insights from a large multicenter registry. J Am Coll Cardiol 2013; 62: 1552−1562. doi: 10.1016/j.jacc.2013.07.040
[11]	Ribeiro HB, Rodés-Cabau J, Blanke P, et al. Incidence, predictors, and clinical outcomes of coronary obstruction following transcatheter aortic valve replacement for degenerative bioprosthetic surgical valves: insights from the VIVID registry. Eur Heart J 2018; 39: 687−695. doi: 10.1093/eurheartj/ehx455
[12]	Dvir D, Leipsic J, Blanke P, et al. Coronary obstruction in transcatheter aortic valve-in-valve implantation: preprocedural evaluation, device selection, protection, and treatment. Circ Cardiovasc Interv 2015; 8: e002079. doi: 10.1161/CIRCINTERVENTIONS.114.002079
[13]	Khan JM, Greenbaum AB, Babaliaros VC, et al. BASILICA trial: one-year outcomes of transcatheter electrosurgical leaflet laceration to prevent TAVR coronary obstruction. Circ Cardiovasc Interv 2021; 14: e010238. doi: 10.1161/CIRCINTERVENTIONS.120.010238
[14]	Lederman RJ, Babaliaros VC, Rogers T, et al. Preventing coronary obstruction during transcatheter aortic valve replacement: from computed tomography to BASILICA. JACC Cardiovasc Interv 2019; 12: 1197−1216. doi: 10.1016/j.jcin.2019.04.052
[15]	Khan JM, Dvir D, Greenbaum AB, 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. doi: 10.1016/j.jcin.2018.01.247
[16]	Khan JM, Greenbaum AB, Babaliaros VC, et al. The BASILICA trial: prospective multicenter investigation of intentional leaflet laceration to prevent TAVR coronary obstruction. JACC Cardiovasc Interv 2019; 12: 1240−1252. doi: 10.1016/j.jcin.2019.03.035
[17]	Khan JM, Babaliaros VC, Greenbaum AB, et al. Preventing coronary obstruction during transcatheter aortic valve replacement: results from the multicenter international BASILICA registry. JACC Cardiovasc Interv 2021; 14: 941−948. doi: 10.1016/j.jcin.2021.02.035
[18]	Carroll JD, Mack MJ, Vemulapalli S, et al. STS-ACC TVT registry of transcatheter aortic valve replacement. J Am Coll Cardiol 2020; 76: 2492−2516. doi: 10.1016/j.jacc.2020.09.595