Dataset Information
Prevention of Bilateral Coronary Obstruction During Valve-In-Valve TAVR With a Self-Expanding Valve: The BABICORN Procedure.
Ontology highlight
ABSTRACT: Objective
We present a case of valve-in-valve transcatheter aortic valve replacement in an 85-year-old woman with severe bioprosthetic aortic valve stenosis at a high risk of left and right coronary artery obstruction. This risk was mitigated by a procedure combining both BASILICA and UNICORN (BABICORN [Bileaflet Alteration with BASILICA and Iatrogenic Cusp Obliteration Using Radiofrequency Needle]) for double leaflet modification.Key steps
Electrosurgical traversal of the right leaflet and creating the electrosurgical loop using 2 guide catheters and an Astato wire within. Electrosurgical traversal of the left leaflet and ballooning the leaflet fenestration. Creating the flying V and lacerating the right leaflet. Serial ballooning and ultimately lacerating the left leaflet. Deployment of the Evolut valve.Potential pitfalls
Catheter entanglement, inadequate leaflet laceration, and stroke or systemic embolization.Take-home message
The BABICORN procedure for double leaflet modification before valve-in-valve transcatheter aortic valve replacement with a self-expanding valve is technically feasible and preserves coronary flow in both native arteries.
SUBMITTER: Ghoneem A
PROVIDER: S-EPMC12371352 | biostudies-literature | 2025 Aug
REPOSITORIES: biostudies-literature
Publications
Prevention of Bilateral Coronary Obstruction During Valve-In-Valve TAVR With a Self-Expanding Valve: The BABICORN Procedure.
JACC. Case reports 20250625 24
<h4>Objective</h4>We present a case of valve-in-valve transcatheter aortic valve replacement in an 85-year-old woman with severe bioprosthetic aortic valve stenosis at a high risk of left and right coronary artery obstruction. This risk was mitigated by a procedure combining both BASILICA and UNICORN (BABICORN [Bileaflet Alteration with BASILICA and Iatrogenic Cusp Obliteration Using Radiofrequency Needle]) for double leaflet modification.<h4>Key steps</h4>Electrosurgical traversal of the right ...[more]