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| http://dx.doi.org/10.1016/j.jcin.2023.10.005 | DOI Listing |
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A review of novel structural heart procedures for the anesthesiologist.
Curr Opin Anaesthesiol
August 2025
Department of Anesthesiology, Tufts Medical Center, Boston, Massachusetts, USA.
Purpose Of Review: There has been significant growth in the volume, complexity, and types of transcatheter cardiac interventions for valvular heart disease over the last 10 years. This review is intended to cover both common structural heart procedures, as well as recent advancements, and the anesthetic considerations of these procedures.
Recent Findings: While contextualizing within a historical perspective, the review covers mitral and tricuspid valve transcatheter edge-to-edge repair, transcatheter mitral, and tricuspid valve replacement, with focus on valve-in-valve, valve-in-ring, and valve-in-native procedures, laceration of the anterior mitral leaflet to prevent outflow obstruction, septal scoring along the midline endocardium, transcatheter aortic valve implantation with focus on bioprosthetic, or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction.
Ultrasound Imaging Integration to Prevent Coronary Obstruction During Valve-In-Valve Transcatheter Aortic Valve Implantation.
Catheter Cardiovasc Interv
September 2025
Department of Medicine, Cardiovascular Division and School of Cardiology, University of Verona, Verona, Italy.
Transcatheter aortic valve-in-valve implantation (TAVI-VIV) in degenerated surgical aortic bioprosthesis is a treatment option in patients with high surgery risk. Some surgical bioprosthesis have a high-risk of coronary artery occlusion (CAO), which is one of the most dreadful complications of TAVI-VIV procedures. Two main techniques such as Bioprosthetic or native Aortic Scallop Intentional Laceration to prevent Iatrogenic Coronary Artery obstruction (BASILICA) and Shortcut (Pi-Cardia, Rehovot, Israel) are used to split the bioprosthetic leaflet to prevent CAO.
View Article and Find Full Text PDFFirst-in-Human BASILICA Before Valve-in-Valve TAVR in a Mechanically Expanded, Legacy Valve.
JACC Case Rep
August 2025
Department of Cardiovascular Medicine, East Carolina University, Greenville, North Carolina, USA.
Background: The Lotus valve is a mechanically expanded transcatheter heart valve with design features that pose challenges for valve-in-valve transcatheter aortic valve replacement (ViV-TAVR). Performing BASILICA (bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction during TAVR) to modify the Lotus leaflets has only been reported in benchtop models.
First-in-human/early Reports Summary: A 79-year-old woman with a degenerated 23-mm Lotus transcatheter heart valve and high risk of coronary occlusion underwent BASILICA, followed by implantation of a 26-mm Evolut FX valve.
Do Not BASILICA the New Valve.
JACC Case Rep
June 2025
Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan, USA.
Object: Bioprosthetic or native Aortic Scallop Intentional Laceration to prevent Iatrogenic Coronary Artery obstruction (BASILICA) is currently the standard technique for leaflet modification in transcatheter aortic valve replacement to overcome coronary obstruction. The technique involves traversal of the coronary cusp with a 0.014-inch coronary wire, snaring the wire, and then lacerating the leaflet with a denuded portion of the wire known as the flying V.
View Article and Find Full Text PDFBASILICA or snorkel stenting to prevent or treat coronary obstruction: Multicenter international COBRA-TAVR registry.
medRxiv
May 2025
Division of Cardiology, Emory Structural Heart and Valve Center, Emory University Hospital Midtown, Atlanta, Georgia, USA.
Coronary obstruction is a rare but life-threatening complication following transcatheter aortic valve replacement (TAVR). Comparative analysis between snorkel stenting and BASILICA (Bioprosthetic or native Aortic Scallop Intentional Laceration to prevent Iatrogenic Coronary Artery obstruction) remain limited. We analyzed 122 patients from the COBRA registry, including 68 who underwent BASILICA and 54 who received snorkel stents.
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