Coronary obstruction (CO) is a potential pitfall for transcatheter aortic valve replacement (TAVR), especially in valve in valve procedures into degenerated surgical or transcatheter prostheses. Bioprosthetic leaflet modification techniques that incorporate electrosurgery are evolving as the preferred strategy to mitigate the risk of CO in high CO risk settings. The UNICORN method is proposed as a more predictable leaflet modification strategy than the earlier described BASILICA approach, but its proponents have hitherto mandated the use of a balloon‐expandable valve (BEV) prosthesis. Many patients have small prostheses and therein face a significant risk of patient prosthesis mismatch with BEV in this setting. This risk may be curtailed if a self‐expanding valve (SEV) prosthesis could be used. Herein described is a modified approach to allow for the utilization of SEV systems in this setting.

中文翻译：

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人类首次：使用射频针 (LLAMACORN) 进行瓣中瓣经导管主动脉瓣置换术时，利用球囊介导的毁坏术进行小叶撕裂，以防止冠状动脉阻塞


冠状动脉阻塞 (CO) 是经导管主动脉瓣置换术 (TAVR) 的一个潜在陷阱，特别是在退化手术或经导管假体的瓣膜手术中。结合电外科的生物假体瓣叶修饰技术正在发展成为在高 CO 风险环境中降低 CO 风险的首选策略。 UNICORN 方法被认为是比之前描述的 BASILICA 方法更可预测的瓣叶修改策略，但其支持者迄今已强制要求使用球囊扩张瓣膜 (BEV) 假体。许多患者拥有小型假体，因此在这种情况下面临着患者假体与 BEV 不匹配的重大风险。如果可以使用自膨胀瓣膜（SEV）假体，这种风险可能会降低。本文描述的是允许在该设置中使用SEV系统的修改方法。