Representative degenerated bioprosthetic aortic valve, at high risk for left coronary obstruction, who underwent BA-BASILICA-TAVR. A) Traversal of the left coronary leaflet. B) Balloon dilatation of the target leaflet after traversal, before laceration. C) Post-deployment angiogram demonstrating patent left coronary, despite leaflet visibly touching the STJ.
Representative patient with severe mitral stenosis, at high risk for LVOT obstruction, who underwent BA-LAMPOON-TMVR. D) Pre-procedural CT shows calcified basal AML. E) AML electrosurgical traversal. F) Lithotripsy pre-dilatation of the AML before laceration. G) After transcatheter mitral valve deployment. H) 3D CT reconstruction showing unobstructed cells and wide splay. (black = anterior leaflet split, white = Sapien3 valve frame, blue = annular calcification.
Abbreviations: AML – anterior mitral leaflet, LCC – left coronary cusp, LVOT – left ventricular outflow tract, STJ – sinotubular junction, TMVR – transcatheter mitral valve replacement