Aortic Valve Leaflet Modification: A Working Group Position Statement on Best Practices and Step-by-Step Guide.
T, R., RN, H., AB, G., CG, B., VC, B., JM, K., M, A.W., M, A., NS, A., & O, d.B. (2026). Aortic Valve Leaflet Modification: A Working Group Position Statement on Best Practices and Step-by-Step Guide.. JACC. Cardiovascular interventions. https://doi.org/10.1016/j.jcin.2026.03.033
T R, RN H, AB G, CG B, VC B, JM K, et al. Aortic Valve Leaflet Modification: A Working Group Position Statement on Best Practices and Step-by-Step Guide.. JACC. Cardiovascular interventions. 2026; doi: 10.1016/j.jcin.2026.03.033
T R, RN H, AB G, et al. Aortic Valve Leaflet Modification: A Working Group Position Statement on Best Practices and Step-by-Step Guide.[J]. JACC. Cardiovascular interventions. 2026. DOI: 10.1016/j.jcin.2026.03.033.
@article{t2026,
author = {Rogers T and Halaby RN and Greenbaum AB and Bruce CG and Babaliaros VC and Khan JM and Abdel-Wahab M and Adam M and Amoroso NS and de Backer O},
title = {Aortic Valve Leaflet Modification: A Working Group Position Statement on Best Practices and Step-by-Step Guide.},
journal = {JACC. Cardiovascular interventions},
year = {2026},
doi = {10.1016/j.jcin.2026.03.033},
note = {PMID: 42264628},
}
TY - JOUR AU - Rogers T AU - Halaby RN AU - Greenbaum AB AU - Bruce CG AU - Babaliaros VC AU - Khan JM AU - Abdel-Wahab M AU - Adam M AU - Amoroso NS AU - de Backer O TI - Aortic Valve Leaflet Modification: A Working Group Position Statement on Best Practices and Step-by-Step Guide. T2 - JACC. Cardiovascular interventions PY - 2026 DO - 10.1016/j.jcin.2026.03.033 AN - PMID:42264628 ER -
Coronary artery obstruction is a potential life-threatening complication of transcatheter aortic valve replacement (TAVR) in all settings including native, valve-in-valve, and redo-TAVR. Risk of obstruction can be identified on preprocedural computed tomography. BASILICA (bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction) effectively prevents TAVR-induced coronary obstruction. Perceived technical complexity, limited availability of purpose-built devices, and scarce training opportunities have hindered the adoption of BASILICA and related techniques. This document synthesizes international experience to provide contemporary best-practice guidance for BASILICA and related leaflet modification strategies. This state-of-the-art review details transcatheter electrosurgery principles; how to determine risk and computed tomographic risk analysis and plan the procedures; a step-by-step guide to electrosurgical BASILICA; tips and tricks for uncommon challenges; scenarios in which BASILICA is unlikely to succeed; and variant techniques such as intraleaflet valve deployment, alternative measures, and dedicated devices. These contemporary best practices can help operators gain or maintain proficiency.