John C Lisko1, Vasilis C Babaliaros1, Robert J Lederman2, Jaffar M Khan3, Toby Rogers3, Adam B Greenbaum4. 1. Structural Heart and Valve Center, Emory University Hospital, Atlanta, GA, USA. 2. Cardiovascular, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA. Electronic address: lederman@nih.gov. 3. Cardiovascular, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA. 4. Structural Heart and Valve Center, Emory University Hospital, Atlanta, GA, USA. Electronic address: Adam.B.Greenbaum@emory.edu.
Abstract
OBJECTIVES: To test custom-shape guiding catheter curves intended to simplify aortic valve leaflet laceration. BACKGROUND: Bioprosthetic Aortic Scallop Intentional Laceration to prevent Iatrogenic Coronary Artery obstruction (BASILICA) is an adjunct to transcatheter aortic valve replacement. It can be technically demanding using popular coronary guiding catheters and catheter-in-guide coaxial systems. New elephant-trunk shaped Pachyderm Left (PAL1,PAL2,PAL3, Launcher, Medtronic) and Right (PJR4) guiding catheters match the geometric requirements to engage aortic cusp hinge points. We evaluate whether these catheters ease BASILICA compared with conventional-shape coronary guiding catheters used in the BASILICA IDE trial. METHODS: This is a single-center, consecutive, retrospective observational cohort of patients who underwent BASILICA for risk of TAVR-induced coronary obstruction defined as virtual valve-to-coronary distance <4 mm, immediately upon commercial availability of the new Pachyderm shaped catheters. Clinical, procedural, and angiographic details were abstracted from medical records of their index procedure, and were compared to adjudicated findings in the BASILICA IDE trial. RESULTS: Nine leaflets in 6 patients were traversed and lacerated using BASILICA and Pachyderm curve guiding catheters for traversal, including three solo left and three doppio left and right leaflets. Leaflet traversal was universally successful. Leaflet time-to-leaflet traversal was shorter using Pachyderm catheters compared with the BASILICA IDE trial (8.3 min (5.6-15) vs 45 min (20, 61), p = 0.016). There were no deaths, strokes, or vascular complications. CONCLUSIONS: The new Pachyderm shaped guiding catheters significantly hastened the leaflet time-to-traversal during BASILICA TAVR. We recommend they be used instead of conventional coronary-shaped guiding catheters. Published by Elsevier Inc.
OBJECTIVES: To test custom-shape guiding catheter curves intended to simplify aortic valve leaflet laceration. BACKGROUND: Bioprosthetic Aortic Scallop Intentional Laceration to prevent Iatrogenic Coronary Artery obstruction (BASILICA) is an adjunct to transcatheter aortic valve replacement. It can be technically demanding using popular coronary guiding catheters and catheter-in-guide coaxial systems. New elephant-trunk shaped Pachyderm Left (PAL1,PAL2,PAL3, Launcher, Medtronic) and Right (PJR4) guiding catheters match the geometric requirements to engage aortic cusp hinge points. We evaluate whether these catheters ease BASILICA compared with conventional-shape coronary guiding catheters used in the BASILICA IDE trial. METHODS: This is a single-center, consecutive, retrospective observational cohort of patients who underwent BASILICA for risk of TAVR-induced coronary obstruction defined as virtual valve-to-coronary distance <4 mm, immediately upon commercial availability of the new Pachyderm shaped catheters. Clinical, procedural, and angiographic details were abstracted from medical records of their index procedure, and were compared to adjudicated findings in the BASILICA IDE trial. RESULTS: Nine leaflets in 6 patients were traversed and lacerated using BASILICA and Pachyderm curve guiding catheters for traversal, including three solo left and three doppio left and right leaflets. Leaflet traversal was universally successful. Leaflet time-to-leaflet traversal was shorter using Pachyderm catheters compared with the BASILICA IDE trial (8.3 min (5.6-15) vs 45 min (20, 61), p = 0.016). There were no deaths, strokes, or vascular complications. CONCLUSIONS: The new Pachyderm shaped guiding catheters significantly hastened the leaflet time-to-traversal during BASILICA TAVR. We recommend they be used instead of conventional coronary-shaped guiding catheters. Published by Elsevier Inc.
Authors: Jaffar M Khan; Danny Dvir; Adam B Greenbaum; Vasilis C Babaliaros; Toby Rogers; Gabriel Aldea; Mark Reisman; G Burkhard Mackensen; Marvin H K Eng; Gaetano Paone; Dee Dee Wang; Robert A Guyton; Chandan M Devireddy; William H Schenke; Robert J Lederman Journal: JACC Cardiovasc Interv Date: 2018-04-09 Impact factor: 11.195
Authors: Jaffar M Khan; Adam B Greenbaum; Vasilis C Babaliaros; Toby Rogers; Marvin H Eng; Gaetano Paone; Bradley G Leshnower; Mark Reisman; Lowell Satler; Ron Waksman; Marcus Y Chen; Annette M Stine; Xin Tian; Danny Dvir; Robert J Lederman Journal: JACC Cardiovasc Interv Date: 2019-06-12 Impact factor: 11.195
Authors: A Pieter Kappetein; Stuart J Head; Philippe Généreux; Nicolo Piazza; Nicolas M van Mieghem; Eugene H Blackstone; Thomas G Brott; David J Cohen; Donald E Cutlip; Gerrit-Anne van Es; Rebecca T Hahn; Ajay J Kirtane; Mitchell W Krucoff; Susheel Kodali; Michael J Mack; Roxana Mehran; Josep Rodés-Cabau; Pascal Vranckx; John G Webb; Stephan Windecker; Patrick W Serruys; Martin B Leon Journal: J Am Coll Cardiol Date: 2012-10-09 Impact factor: 24.094
Authors: Robert J Lederman; Vasilis C Babaliaros; Toby Rogers; Jaffar M Khan; Norihiko Kamioka; Danny Dvir; Adam B Greenbaum Journal: JACC Cardiovasc Interv Date: 2019-07-08 Impact factor: 11.195
Authors: Emily Perdoncin; Christopher G Bruce; Vasilis C Babaliaros; Dursun Korel Yildirim; Jeremiah P Depta; James M McCabe; Patrick T Gleason; Joe Xie; Kendra J Grubb; Gaetano Paone; Keshav Kohli; Norihiko Kamioka; Jaffar M Khan; Toby Rogers; Robert J Lederman; Adam B Greenbaum Journal: Circ Cardiovasc Interv Date: 2021-10-22 Impact factor: 6.546
Authors: Jaffar M Khan; Adam B Greenbaum; Vasilis C Babaliaros; Danny Dvir; Mark Reisman; James M McCabe; Lowell Satler; Ron Waksman; Marvin H Eng; Gaetano Paone; Marcus Y Chen; Christopher G Bruce; Annette M Stine; Xin Tian; Toby Rogers; Robert J Lederman Journal: Circ Cardiovasc Interv Date: 2021-05-18 Impact factor: 6.546