Simultaneous valve-in-valve procedure and life-saving coronary angioplasty in a patient with low coronary artery ostia

Valve-in-valve TAVR using BASILICA technique and cerebral protection in a patient with severe dysfunction of the aortic bioprosthesis

“…The feasibility of a complete percutaneous approach in transfemoral TAVR was demonstrated, even in complex scenarios, such as valve-in-valve (ViV) procedures [ 1 ]. ViV TAVR is associated both with a higher stroke risk due to biodebris released from the degenerated bioprosthesis and increased risk of coronary occlusion, especially in patients with a short distance between the bioprosthesis and coronary ostia [ 2 ]. In such patients, the “chimney technique” or BASILICA technique (Bioprosthetic or Native Aortic Scallop Intentional Laceration to Prevent Iatrogenic Coronary Artery Obstruction) can be used to prevent coronary occlusion [ 2 ].…”

“…ViV TAVR is associated both with a higher stroke risk due to biodebris released from the degenerated bioprosthesis and increased risk of coronary occlusion, especially in patients with a short distance between the bioprosthesis and coronary ostia [ 2 ]. In such patients, the “chimney technique” or BASILICA technique (Bioprosthetic or Native Aortic Scallop Intentional Laceration to Prevent Iatrogenic Coronary Artery Obstruction) can be used to prevent coronary occlusion [ 2 ]. BASILICA is a novel transcatheter electrosurgical technique which increases the safety of ViV TAVR, but also enhances the risk of stroke [ 3 ].…”