TCT-728 Evolving Strategies to Prevent Coronary and Left Ventricular Outflow Tract Obstruction: The UNICORN and BATMAN Techniques – A Multicenter Study
Recommended Citation
Hebbo E, Camaj A, Noman A, Ueyama H, D'Angelo J, Alcaro L, Laham R, Giustino G, Halboni A, Villablanca P, Hildick-Smith D, Saxon J, Khan J, Chhatriwalla A, Rogers T, Pop A, Ahmad Y, Lederman R, Gleason P, Lisko J, Shekiladze N, Greenbaum A, Babaliaros V, Byku I. TCT-728 Evolving Strategies to Prevent Coronary and Left Ventricular Outflow Tract Obstruction: The UNICORN and BATMAN Techniques – A Multicenter Study. J Am Coll Cardiol 2025; 86(17):B317-B318.
Document Type
Conference Proceeding
Publication Date
10-28-2025
Publication Title
J Am Coll Cardiol
Abstract
Background: Strategies for preventing coronary or left ventricular outflow tract (LVOT) obstruction during TAVR and TMVR are becoming more prevalent. This study describes efficacy and safety of Undermining Coronary Obstruction with Radiofrequency Needle Ablation (UNICORN) and Balloon-Assisted Translocation of the Anterior Mitral Leaflet (BATMAN) procedures. Methods: This study was a retrospective, multicenter study of patients who underwent UNICORN during TAVR and BATMAN during TMVR between March 2024 and May 2025. Primary success was UNICORN or BATMAN without periprocedural coronary or LVOT obstruction, reintervention or death. The primary safety endpoint was freedom from major adverse cardiovascular events and major vascular complications at 30 days. Results: A total of 52 UNICORN and 25 BATMAN patients were treated at 11 different sites. UNICORN patients primarily underwent valve-in-surgical valve procedure (55.8%) and BATMAN patients primarily underwent valve-in-mitral annular calcification (40%). Procedural success was 96.2% in UNICORN patients (2 patients with coronary obstruction). Primary safety at 30 days was 86.5% (4 strokes, 3 major vascular complications and 1 myocardial infarction). In the BATMAN group, procedural success was 64%. There were 5 periprocedural deaths, 3 cases of LVOT obstruction, and 3 reinterventions. Of the deaths, 2 died following intestinal ischemic events presumed embolic; 1 died of cardiogenic shock in the procedure; 1 patient died secondary to valve embolization; 1 patient sustained an intraprocedural left ventricular injury and died during repair. Primary safety at 30 days was 76%, with 1 post-discharge myocardial infarction. [Formula presented] Conclusion: UNICORN and BATMAN procedures are feasible in a high-risk population. Further experience is needed to optimize patient selection and improve short term outcomes. Categories: STRUCTURAL: Valvular Disease and Intervention: Aortic
Volume
86
Issue
17
First Page
B317
Last Page
B318
