Article Details

Transcatheter aortic valve replacement (TAVR) procedural rates have been increasing over past decade and there is growing need for treatment with valve in valve procedures for degenerative bioprosthetic valves. Valve in Valve (ViV) procedures are more complicated and the critical limitation being coronary obstruction which can be life threatening in aging patients with underlying comorbidities. Newer procedural techniques to address this issue include bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction (BASILICA) and undermining iatrogenic coronary obstruction with radiofrequency needle (UNICORN) have been developed with one or two successful cases reported in literature. We present here successful UNICORN case in our university hospital for ViV TAVR within a prior Bioprosthetic valve.