{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T04:29:59Z","timestamp":1785558599774,"version":"3.56.0"},"reference-count":29,"publisher":"Radcliffe Medical Media Ltd","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/legalcode"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Cardiol"],"abstract":"<jats:p>Coronary artery obstruction is a commonly fatal complication occurring after transcatheter aortic valve replacement. The main mechanisms are displacement of valve leaflets to overlie the coronary ostium or sequestration of the coronary sinus. The bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction (BASILICA) procedure mitigates this risk. It entails deliberate laceration of the valve leaflet to allow it to splay apart during transcatheter heart valve implantation, thus maintaining coronary perfusion. Patient selection is based on key anatomical and imaging-derived parameters. Catheter electrosurgery involves using electrified wires to permit puncture and laceration of the leaflet. The steps undertaken to achieve a successful BASILICA procedure include access, traversal, puncture, laceration and completion, which are described in this review. Challenges faced by the BASILICA operator and practical solutions are also discussed.<\/jats:p>","DOI":"10.15420\/ecr.2025.06","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T18:26:31Z","timestamp":1783535191000},"source":"Crossref","is-referenced-by-count":1,"title":["BASILICA Technique: Why, When and How?"],"prefix":"10.15420","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1527-2263","authenticated-orcid":false,"given":"Harminder S","family":"Gill","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00mj4n083","id-type":"ROR","asserted-by":"publisher"}],"name":"St. Francis Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6099-0753","authenticated-orcid":false,"given":"Jaffar M","family":"Khan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00mj4n083","id-type":"ROR","asserted-by":"publisher"}],"name":"St. Francis Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6096","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"VARC-3 Writing Committee. 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J Am Coll Cardiol 2013;62:1552\u201362. https:\/\/doi.org\/10.1016\/j.jacc.2013.07.040; PMID:\u00a023954337."},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Mercanti F, Rosseel L, Neylon A, et al. Chimney stenting for coronary occlusion during TAVR: insights from the chimney registry. JACC Cardiovasc Interv 2020;13:751\u201361. https:\/\/doi.org\/10.1016\/j.jcin.2020.01.227; PMID:\u00a032192695.","DOI":"10.1016\/j.jcin.2020.01.227"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Bor WL, Chan Pin Yin DRPP, Brouwer J, et al. Assessment of the academic research consortium for high bleeding risk criteria in patients undergoing TAVR. JACC Cardiovasc Interv 2021;14:1265\u20137. https:\/\/doi.org\/10.1016\/j.jcin.2021.01.007; PMID:\u00a034112466.","DOI":"10.1016\/j.jcin.2021.01.007"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Lederman RJ, Babaliaros VC, Rogers T, et al. Preventing coronary obstruction during transcatheter aortic valve replacement: from computed tomography to BASILICA. JACC Cardiovasc Interv 2019;12:1197\u2013216. https:\/\/doi.org\/10.1016\/j.jcin.2019.04.052; PMID:\u00a031272666.","DOI":"10.1016\/j.jcin.2019.04.052"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Bruce CG, Khan JM, Rogers T, et al. Transcatheter electrosurgery: a narrative review. Circ Cardiovasc Interv 2023;16:e012019. https:\/\/doi.org\/10.1161\/CIRCINTERVENTIONS.122.012019; PMID:\u00a036799217.","DOI":"10.1161\/CIRCINTERVENTIONS.122.012019"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Khan JM, Dvir D, Greenbaum AB, et al. Transcatheter laceration of aortic leaflets to prevent coronary obstruction during transcatheter aortic valve replacement: concept to first-in-human. 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JACC Cardiovasc Interv 2024;17:742\u201352. https:\/\/doi.org\/10.1016\/j.jcin.2024.01.007; PMID:\u00a038538170.","DOI":"10.1016\/j.jcin.2024.01.007"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Chan KE, Tai-Leung Chan D, Lam CS, et al. First-in-human UNdermining Iatrogenic Coronary Obstruction with Radiofrequency Needle (UNICORN) procedure during valve-in-valve transcatheter aortic valve replacement. Circ Cardiovasc Interv 2022;15:928\u201331. https:\/\/doi.org\/10.1161\/CIRCINTERVENTIONS.122.012399; PMID:\u00a036268707.","DOI":"10.1161\/CIRCINTERVENTIONS.122.012399"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Buchanan CE, Iskander M, Anwaruddin S, Mason PJ. Novel valve-in-surgical bioprosthetic transcatheter aortic valve replacement: UNdermining Iatrogenic Coronary Obstruction with Radiofrequency Needle (UNICORN). 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The challenge of valve-in-valve procedures in degenerated Mitroflow bioprostheses and the advantage of using the JenaValve transcatheter heart valve. EuroIntervention 2014;10:990\u20134. https:\/\/doi.org\/10.4244\/EIJV10I8A167; PMID:\u00a024647151.","DOI":"10.4244\/EIJV10I8A167"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Khan JM, Bruce CG, Babaliaros VC, et al. TAVR roulette: caution regarding BASILICA laceration for TAVR-in-TAVR. 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