BASILICA Procedure

Bioprosthetic Aortic Scallop Intentional Laceration to prevent Iatrogenic Coronary Artery obstruction

Coronary obstruction is a potentially life-threatening complication of transcatheter aortic valve replacement (TAVR) in both bioprosthetic valve-in-valve procedures as well as in native valve disease. As a result, advanced cardiac computed tomography (CT) and echocardiographic pre-procedure planning are required to evaluate patients undergoing TAVR to assess the risk for coronary obstruction. The BASILICA (Bioprosthetic Aortic Scallop Intentional Laceration to prevent Iatrogenic Coronary Artery obstruction) procedure was developed in an effort to reduce this risk and allow for safe TAVR deployment. This investigational procedure utilizes an electrified catheter-based technique to lacerate the aortic cusps prior to percutaneous aortic valve implantation.

Access:

LFA:

6F sheath x 2

5F sheath

RFA:

4F -> 10F -> 16F

Catheters:

6F EBU 3.5 90cm guidecatheter

7F JR4 guidecatheter

7F or 8F AL3 guidecatheter (standby)

5F IM diagnostic catheter

6F pigtail catheter

5F pigtail catheter

5F MPA catheter

16Fr Gore Dryseal or 12F Mullins 75cm

6F Finecross or Piggyback catheter

Safari wire

Gooseneck snare 20mm or 25mm

Amplatz superstiff wire

Tuohy borrs (hemostasis valve) for Gooseneck snare

Astato 20g 300cm angioplasty wire

Diathermy pen and machine

BMW 300cm angioplasty wire

Hemostasis valve x 2

60ml with dextrose water x 2

Bionector or one-way valve

Crossing system:

RFA

Gooseneck snare 25mm, inside a...

6F JR4 diagnostic catheter

LFA

Astato 20g 300cm angioplasty wire (straight tip), inside a...

5F MPA diagnostic catheter inside a...

6F EBU 3.5 90cm guidecatheter

Attach the end of Astato to the diathermy pen with 30 pure cut only

Usual TAVI equipment