TY  - BOOK
AU  - Rogers, Toby
TI  - Preventing Coronary Obstruction During Transcatheter Aortic Valve Replacement: From Computed Tomography to BASILICA. [Review]
SN  - 1936-8798
PY  - 2019///
KW  - *Aortic Valve/su [Surgery]
KW  - *Coronary Stenosis/pc [Prevention & Control]
KW  - *Electrosurgery
KW  - *Iatrogenic Disease/pc [Prevention & Control]
KW  - *Tomography, X-Ray Computed
KW  - *Transcatheter Aortic Valve Replacement
KW  - Aortic Valve/dg [Diagnostic Imaging]
KW  - Aortic Valve/pp [Physiopathology]
KW  - Bioprosthesis
KW  - Coronary Circulation
KW  - Coronary Stenosis/dg [Diagnostic Imaging]
KW  - Coronary Stenosis/et [Etiology]
KW  - Coronary Stenosis/pp [Physiopathology]
KW  - Electrosurgery/ae [Adverse Effects]
KW  - Electrosurgery/is [Instrumentation]
KW  - Heart Valve Prosthesis
KW  - Humans
KW  - Predictive Value of Tests
KW  - Prosthesis Design
KW  - Risk Assessment
KW  - Risk Factors
KW  - Transcatheter Aortic Valve Replacement/ae [Adverse Effects]
KW  - Transcatheter Aortic Valve Replacement/is [Instrumentation]
KW  - Treatment Outcome
KW  - Vascular Patency
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
KW  - Review
N1  - Available online through MWHC library: 2008 - present
N2  - Copyright Published by Elsevier Inc; Coronary artery obstruction is an uncommon but devastating complication of transcatheter aortic valve replacement (TAVR). Computed tomography appears to be a sensitive but nonspecific predictor of coronary artery obstruction. Transcatheter approaches to prevent and treat coronary artery obstruction, such as "snorkel" stenting, are unsatisfactory because of serious early and late ischemic complications. Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction during TAVR (BASILICA) is an early-stage transcatheter procedure to prevent coronary artery obstruction. It works by splitting the native or bioprosthetic leaflets so that they splay after TAVR and preserve coronary artery inflow. Because of the paucity of suitable alternatives, there is interest in the BASILICA technique despite its infancy. This tutorial review summarizes current thinking about how to predict and prevent coronary artery obstruction using BASILICA. First, the authors depict the main pathophysiological mechanisms of TAVR-associated coronary artery obstruction, along with the factors thought to contribute to coronary obstruction. Next, the authors provide a step-by-step guide to analyzing pre-procedural computed tomographic findings to assess obstruction risk and, if desirable, to plan BASILICA. Next, the authors describe the mechanisms underlying transcatheter electrosurgery. Finally, they provide step-by-step guidance on how to perform the procedure, along with a required equipment list
UR  - https://dx.doi.org/10.1016/j.jcin.2019.04.052
ER  -