Multicenter Experience of Aortic Valve Leaflet Modification in TAVR
3
Issued Date
2026-07-01
Resource Type
eISSN
27723747
Scopus ID
2-s2.0-105043101912
Journal Title
Jacc Asia
Volume
6
Issue
7
Start Page
1046
End Page
1058
Rights Holder(s)
SCOPUS
Bibliographic Citation
Jacc Asia Vol.6 No.7 (2026) , 1046-1058
Suggested Citation
Wong C.K., Cheung-Chi Lam S., Yin W.H., Lee Y.T., Wongpraparut N., Gurvitch R., Chandavimol M., Chak-Yu So K., Un K.C., Alston Conrad Chiu H.O., Tsao T.P., Brooks M., Ngernsritrakul T., Lai L.K.L., Ka-Ho Kam K., Tai-Leung Chan D., Tang G.H.L., Eric Chan K.Y., Poon K. Multicenter Experience of Aortic Valve Leaflet Modification in TAVR. Jacc Asia Vol.6 No.7 (2026) , 1046-1058. 1058. doi:10.1016/j.jacasi.2026.04.017 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/117793
Title
Multicenter Experience of Aortic Valve Leaflet Modification in TAVR
Author's Affiliation
The University of Queensland
Chinese University of Hong Kong
National Yang-Ming University Taiwan
Royal Melbourne Hospital
Queen Mary Hospital Hong Kong
The University of Hong Kong Li Ka Shing Faculty of Medicine
Siriraj Hospital
Ramathibodi Hospital
National Defense University Taiwan
The Prince Charles Hospital
National Taipei University of Nursing and Health Sciences
Sinai Health System
Cheng Hsin General Hospital
Grantham Hospital Hong Kong
Chinese University of Hong Kong
National Yang-Ming University Taiwan
Royal Melbourne Hospital
Queen Mary Hospital Hong Kong
The University of Hong Kong Li Ka Shing Faculty of Medicine
Siriraj Hospital
Ramathibodi Hospital
National Defense University Taiwan
The Prince Charles Hospital
National Taipei University of Nursing and Health Sciences
Sinai Health System
Cheng Hsin General Hospital
Grantham Hospital Hong Kong
Corresponding Author(s)
Other Contributor(s)
Abstract
Background Safety and efficacy of leaflet modification in transcatheter aortic valve replacement (TAVR) to reduce coronary obstruction risk have been demonstrated in North American and European populations, but real-world data from the Asia-Pacific remain limited. Objectives The authors aimed to report the real-world procedural and clinical outcomes of bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction (BASILICA) and undermining iatrogenic coronary obstruction with radiofrequency needle (UNICORN) leaflet modification techniques during TAVR in Asia-Pacific. Methods This multicenter retrospective observational registry included consecutive patients undergoing aortic valve leaflet modification during TAVR across 7 centers in the Asia-Pacific from April 2019 to January 2026. Primary outcome was procedural success, defined as successful leaflet traversal, leaflet modification, and transcatheter heart valve implantation without coronary obstruction, emergent surgery, stroke, or mortality in 30 days. Secondary outcomes included 30-day major adverse events per the Valve Academic Research Consortium 3 definitions. Results Among 100 patients, 72.2% were female with a median age of 80.0 years. BASILICA was performed in 67.0%, UNICORN in 30.0%, and BASILICA-UNICORN in 3.00%. Annual case volume increased nearly 10-fold during the study period. Index valves were predominantly small (≤21 mm) surgical bioprostheses. Procedural success was achieved in 85.1% of BASILICA patients and 96.7% of UNICORN patients. Coronary obstruction occurred in 2.99% of BASILICA patients. Conclusions Transcatheter electrosurgical leaflet modification techniques are associated with acceptable short-term outcome in high-risk patients undergoing TAVR in the Asia-Pacific region.