BASILICA

(Bioprosthetic Aortic Scallop Intentional Laceration to prevent Iatrogenic Coronary Artery obstruction)

ACC.org BASILICA Page

Open

• Dryseal sheath- size depending on valve, verify with MD before opening.
• 6fr MP1 guide catheter
• 7F sheath
• .018 Platinum Plus guidewire 260 cm
• Gooseneck Snare 20mm- VERIFY SIZE BEFORE OPENING
• 6 Fr AL2 (for LCA BASILICA) -OR- 6 FR PJR4 Guide (For RCA BASILICA)
• .014 Astato xs 20 guidewire 180cm
• Piggyback wire converter 4fr x 145

• Bovie pen
  • Grounding Pad
  • Bovie machine
• (2) Watchdog devices
• (2) Stopcocks
• 4 hemostats
• (3) 60ml syringes
• (2) 12 inch extension tubing
• Bowl of D5

Standby

• Tip deflecting wire
• Gooseneck snares 25, 30mm
• .035 QuickCross
• AL2, AL3, EBU4, EBU 3.75 (Left leaflet)
• MPA1, JR4, IM, AR1 (Right leaflet)

Procedure

• Setup and access is the same as TAVR except a 14F Dryseal sheath is inserted initially instead of the ESheath.
  • Bovie set at 30 CUT ONLY.
• AL1 advanced over J wire through 7F sheath. Wire exchanged for straight stiff glidewire for valve crossing.
• AL1 exchanged over the wire for MP1 Guide with watchdog and stopcock attached.
• Platinum Plus wire is preshaped by MD and inserted through MP to retain LV access.
• Snare advanced through MP alongside Platinum Plus.
• BASILICA catheter advanced through Dryseal sheath with watchdog and stopcock attached.
• Kinked Astato wire advanced through BASILICA catheter.
• Hand injection performed to verify position of BASILICA catheter.
• Astato wire connected to bovie with 2 hemostats.
• RF applied as Astato wire advanced.
• Once wire penetrates leaflet it is snared and pulled into MP1.
• Platinum Plus wire removed
• Pacing wire advanced and tested
• AL1 advanced next to BASILICA catheter and valve recrossed in standard fashion.
• 60ml D5 filled syringes and extension tubing attached to sideports of guides and injected simultaneously during leaflet laceration.
• MP removed. BASILICA catheter removed.
• Amplatz ES advanced through AL1 and AL1 removed.
• Pigtail advanced to coronary cusp
• Dryseal exchanged for ESheath
• Do a TAVR.

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Approved: MM/YY