Balloon-Assisted Leaflet Laceration to Prevent Coronary Obstruction During TAVR: Step-by-Step Modified UNICORN.

ABSTRACT:

Objectives

Coronary obstruction (CO) is a life-threatening complication of transcatheter aortic valve replacement (TAVR). Undermining iatrogenic coronary obstruction with radiofrequency needle (UNICORN) has been recently described as a novel strategy to prevent CO during TAVR. We describe here the step-by-step technique of a modified version of UNICORN.

Key steps

First, the target leaflet is traversed using transcatheter electrosurgery with a 0.014-inch wire. After successful leaflet traversal, the leaflet is first ballooned with a noncompliant coronary balloon. Then, the wire is exchanged with a stiff 0.035-inch wire. Over a 0.035-inch wire, the leaflet is completely lacerated with a large noncompliant balloon, and finally the transcatheter heart valve is implanted.

Pote

SUBMITTER: Giustino G 

PROVIDER: S-EPMC12441510 | biostudies-literature | 2025 Jul

REPOSITORIES: biostudies-literature