Equipment entrapment during redo-TAVR with successful BASILICA procedure

Waqas T Qureshi; Matthew Parker; Jennifer Walker; Nikolaos Kakouros

doi:10.1002/ccd.29485

Equipment entrapment during redo-TAVR with successful BASILICA procedure

Catheter Cardiovasc Interv. 2021 Aug 1;98(2):E320-E323. doi: 10.1002/ccd.29485. Epub 2021 Jan 23.

Authors

Waqas T Qureshi¹, Matthew Parker¹, Jennifer Walker², Nikolaos Kakouros¹

Affiliations

¹ Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
² Division of Cardiothoracic Surgery, University of Massachusetts Medical School, Worcester, Massachusetts, USA.

PMID: 33484070
DOI: 10.1002/ccd.29485

Abstract

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.

Keywords: aortic stenosis; bioprosthetic valve failure; transcatheter aortic valve replacement.

Publication types

Case Reports

MeSH terms

Aortic Valve / diagnostic imaging
Aortic Valve / surgery
Aortic Valve Stenosis* / diagnostic imaging
Aortic Valve Stenosis* / surgery
Bioprosthesis*
Heart Valve Prosthesis*
Humans
Prosthesis Design
Risk Factors
Transcatheter Aortic Valve Replacement* / adverse effects
Treatment Outcome