Leaflet Modification Technique With UNICORN in Failed Aortic Bioprosthesis
Issued Date
2026-06-22
Resource Type
ISSN
19368798
eISSN
18767605
Scopus ID
2-s2.0-105041625957
Journal Title
Jacc Cardiovascular Interventions
Volume
19
Issue
12
Start Page
1565
End Page
1578
Rights Holder(s)
SCOPUS
Bibliographic Citation
Jacc Cardiovascular Interventions Vol.19 No.12 (2026) , 1565-1578
Suggested Citation
Chan K.Y.E., Un K.C., Chiu H.O.A.C., Tai-Leung Chan D., Sze S.Y., Yin W.H., Lee Y.T., Lee Y.T., Lin P., Abdel-Wahab M., Pop A.M., Tchetche D., Freeman P., De Backer O., Poon K., Chandavimol M., Tang G.H.L., Wong C.K., Lam S.C.C. Leaflet Modification Technique With UNICORN in Failed Aortic Bioprosthesis. Jacc Cardiovascular Interventions Vol.19 No.12 (2026) , 1565-1578. 1578. doi:10.1016/j.jcin.2026.04.031 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/117435
Title
Leaflet Modification Technique With UNICORN in Failed Aortic Bioprosthesis
Author's Affiliation
The University of Queensland
Karolinska Universitetssjukhuset
Rigshospitalet
National Yang-Ming University Taiwan
China Medical University
Queen Mary Hospital Hong Kong
The University of Hong Kong Li Ka Shing Faculty of Medicine
Ramathibodi Hospital
Herzzentrum Leipzig
The Prince Charles Hospital
Sinai Health System
Cheng Hsin General Hospital
Clinique Pasteur
Grantham Hospital Hong Kong
Alexian Brothers Medical Center
Karolinska Universitetssjukhuset
Rigshospitalet
National Yang-Ming University Taiwan
China Medical University
Queen Mary Hospital Hong Kong
The University of Hong Kong Li Ka Shing Faculty of Medicine
Ramathibodi Hospital
Herzzentrum Leipzig
The Prince Charles Hospital
Sinai Health System
Cheng Hsin General Hospital
Clinique Pasteur
Grantham Hospital Hong Kong
Alexian Brothers Medical Center
Corresponding Author(s)
Other Contributor(s)
Abstract
The UNICORN (undermining iatrogenic coronary obstruction with radiofrequency needle) technique was developed in 2022 to reduce the risk for coronary obstruction during valve-in-valve transcatheter aortic valve replacement. The procedure involves traversing the target leaflet with an electrified wire, followed by serial dilation with coronary and peripheral balloons. A balloon-expandable valve is then delivered into the de novo fenestration for intraleaflet deployment. As the balloon-expandable valve expands, the target leaflet is opened and displaced away from the at-risk coronary ostium, resulting in a minimal neoskirt on the target side. Since its introduction, the technique has been adopted at numerous centers worldwide, with various modifications and adaptations. In this paper, a step-by-step description of the UNICORN procedure is provided, and troubleshooting strategies for potential challenges are discussed.