Valvular & structural heart diseaseCohort study

Leaflet Splitting to Prevent TAVR-Induced Coronary Obstruction in Stented vs Stentless Surgical Bioprosthetic Valves

JACC Cardiovasc IntervPublished

  • Registry-based cohort study
  • multicentre

Authors' conclusion

BASILICA is technically feasible for both stented and stentless valves. However, stentless valves had a higher rate of partial CAO after BASILICA and TAVR and may therefore require additional or alternative coronary artery protection measures in selected patients.

Study context

Population
Patients undergoing BASILICA and valve-in-valve transcatheter aortic valve replacement (TAVR), EURO-BASILICA registryEURO-BASILICA registry
Participants
131 patients
Exposure
Stented vs Stentless
  • Stentedn = 115reference
  • Stentlessn = 16

Main finding

As reported in the abstract

Target leaflet-related CAO

Target leaflet-related CAO

Partial, non-flow-limiting CAO

P < 0.001

  • Stentless vs Stented: P < 0.001 — target leaflet-related coronary artery obstruction (CAO)

Observational data: associations, not effects.

Further findings

Leaflet length

P < 0.001

Contrast medium

P < 0.001

Fluoroscopy time

P = 0.023

Leaflet length

Risk for CAO comparable

Fluoroscopy time

Trend toward longer procedure time with stentless valves

Safety

In-hospital complications, 30-day outcomes, late CAO and MI · 1-year follow-up

In-hospital complications and 30-day outcomes similar
No late CAO or MI during 1-year follow-up

Original publication

Leaflet Splitting to Prevent TAVR-Induced Coronary Obstruction in Stented vs Stentless Surgical Bioprosthetic Valves. JACC Cardiovasc Interv. Published 8 June 2026. doi:10.1016/j.jcin.2026.01.312

Summarised from the published abstract; every number is checked against it