Coronary Protection to Prevent Coronary Obstruction During TAVR

Palmerini, Tullio; Chakravarty, Tarun; Saia, Francesco; Bruno, Antonio Giulio; Bacchi-Reggiani, MStat Maria-Letizia; Marrozzini, Cinzia; Patel, Chinar; Patel, Vivek; Testa, Luca; Bedogni, Francesco; Ancona, Marco; Montorfano, Matteo; Chieffo, Alaide; Olivares, Paolo; Bartorelli, Antonio L.; Buscaglia, Angelo; Porto, Italo; Nickenig, Georg; Grube, Eberhard; Sinning, Jan‐Malte; Carlo, Marco De; Petronio, Anna Sonia; Barbanti, Marco; Tamburino, Corrado; Iadanza, Alessandro; Burzotta, Francesco; Trani, Carlo; Fraccaro, Chiara; Tarantini, Giuseppe; Aranzulla, Tiziana Claudia; Benedictis, Mauro De; Pagnotta, Paolo; Stefanini, Giulio G.; Miura, Mizuki; Taramasso, Maurizio; Kang, Jeehoon; Kim, Hyo–Soo; Codner, Pablo; Kornowski, Ran; Pelliccia, Francesco; Vignali, Luigi; Taglieri, Nevio; Ghetti, Gabriele; Leone, Alessandro; Galiè, Nazzareno; Makkar, Raj

doi:10.1016/j.jcin.2019.11.024

Cited by 59 publications

(27 citation statements)

References 14 publications

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“…Coronary protection with a stent can be useful but the results of this technique have been variable. In a series of 236 patients where 60% of protected coronaries needed stent implantation, there were two definite stent thromboses out of 143 stented patients and four delayed obstructions in unstented patients 12 . A recent registry of TAVR‐in‐TAVR showed only one case out of 50 re‐do patients that occurred in a balloon expandable valve after implantation of another balloon expandable valve 13 .…”

Section: Discussionmentioning

confidence: 99%

Equipment entrapment during redo‐TAVR with successful BASILICA procedure

Qureshi

Parker

Walker

et al. 2021

Cathet Cardio Intervent

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Transcatheter aortic valve replacement (TAVR) for transcatheter heart valve failure has been suggested for high‐risk patients. TAVR‐in‐TAVR, however, may lead to complex leaflet interactions causing coronary ostial obstruction, which is a devastating complication. Coronary protection with provisional stent placement may be challenging. We describe the first percutaneous transaxillary case of TAVR‐in‐TAVR with Bioprosthetic Aortic Scallop Intentional Laceration to prevent Iatrogenic Coronary Artery obstruction (BASILICA) where guide catheters used for coronary protection were entrapped between the valve frames. We describe anatomical predictors and management considerations. Operators should be aware of this important complication during TAVR‐in‐TAVR valve placement.

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Section: Discussionmentioning

confidence: 99%

Equipment entrapment during redo‐TAVR with successful BASILICA procedure

Qureshi

Parker

Walker

et al. 2021

Cathet Cardio Intervent

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“…In the majority of cases pre-emptive wiring of the coronary ostia is performed before valve deployment. In high-risk patients, this involves pre-emptive stenting of the coronary ostia using the chimney technique, as this strategy has been associated with improved outcomes compared to pre-emptive wiring alone (114,136). In addition, the aforementioned BASILICA procedure has emerged as a novel leaflet splitting technique in TAVR patients, especially in those undergoing ViV procedures (137).…”

Section: Low Coronary Ostiamentioning

confidence: 99%

Challenging Anatomies for TAVR—Bicuspid and Beyond

Saad

Seoudy

Frank

2021

Front. Cardiovasc. Med.

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Transcatheter aortic valve replacement has emerged as the standard treatment for the majority of patients with symptomatic aortic stenosis. As transcatheter aortic valve replacement expands to patients across all risk groups, optimal patient selection strategies and device implantation techniques become increasingly important. A significant number of patients referred for transcatheter aortic valve replacement present with challenging anatomies and clinical indications that had been historically considered a contraindication for transcatheter aortic valve replacement. This article aims to highlight and discuss some of the potential obstacles that are encountered in clinical practice with a particular emphasis on bicuspid aortic valve disease.

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“…If the predicted risk of coronary occlusion is very high, coronary artery protection with a safety wire (normally also with a pre-loaded stent) is recommended. In selected cases with a near 100% probability of occlusion, a pre-stenting of the coronary ostia is performed (“chimney technique”) [ 115 , 116 , 117 ].…”

Section: Valve-in-valve and Valve-in-tavimentioning

confidence: 99%

Advancements in Transcatheter Aortic Valve Implantation: A Focused Update

et al. 2021

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Transcatheter aortic valve implantation (TAVI) has become the leading technique for aortic valve replacement in symptomatic patients with severe aortic stenosis with conventional surgical aortic valve replacement (SAVR) now limited to patients younger than 65–75 years due to a combination of unsuitable anatomies (calcified raphae in bicuspid valves, coexistent aneurysm of the ascending aorta) and concerns on the absence of long-term data on TAVI durability. This incredible rise is linked to technological evolutions combined with increased operator experience, which led to procedural refinements and, accordingly, to better outcomes. The article describes the main and newest technical improvements, allowing an extension of the indications (valve-in-valve procedures, intravascular lithotripsy for severely calcified iliac vessels), and a reduction of complications (stroke, pacemaker implantation, aortic regurgitation).

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Coronary Protection to Prevent Coronary Obstruction During TAVR

Cited by 59 publications

References 14 publications

Equipment entrapment during redo‐TAVR with successful BASILICA procedure

Equipment entrapment during redo‐TAVR with successful BASILICA procedure

Challenging Anatomies for TAVR—Bicuspid and Beyond

Advancements in Transcatheter Aortic Valve Implantation: A Focused Update

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