BASILICA or snorkel stenting to prevent or treat coronary obstruction: Multicenter international COBRA-TAVR registry
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Coronary obstruction is a rare but life-threatening complication following transcatheter aortic valve replacement (TAVR). Comparative analysis between snorkel stenting and BASILICA (Bioprosthetic or native Aortic Scallop Intentional Laceration to prevent Iatrogenic Coronary Artery obstruction) remain limited. We analyzed 122 patients from the COBRA registry, including 68 who underwent BASILICA and 54 who received snorkel stents. In-hospital survival was numerically higher in the BASILICA group compared to the snorkel stent group (97% vs. 89%). BASILICA was also associated with lower rates of life-threatening bleeding (0.0% vs. 10%) and major vascular complications (1.5% vs. 12%). In patients at risk, a preemptive BASILICA strategy may offer an attractive approach for primary prevention of coronary obstruction in patients undergoing TAVR.
