Transcatheter Laceration of Aortic Leaflets to Prevent Coronary Obstruction During Transcatheter Aortic Valve Replacement: Concept to First-in-Human.

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.

SUBMITTER: Khan JM 

PROVIDER: S-EPMC6309616 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature