ArticleJACC. Case reports2026
Simplified UNICORN for Transcatheter Aortic Valve Replacement.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
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Abstract
objectiveThe UNICORN (undermining iatrogenic coronary obstruction with radiofrequency needle) technique represents an emerging leaflet modification strategy for patients undergoing transcatheter aortic valve replacement (TAVR) at risk for coronary obstruction. We describe a simplified UNICORN procedure in patients undergoing valve-in-valve and native TAVR. KEY STEPS: This approach employs radiofrequency energy to traverse the base of the prosthetic aortic leaflet, followed by serial balloon inflations to create a large fenestration and subsequent transcatheter heart valve deployment, removing the risk of leaflet obstruction. POTENTIAL PITFALLS: Technical challenges include severely calcified leaflets that impede balloon advancement, the potential for leaflet fragment embolization with resultant coronary artery occlusion, and acute aortic insufficiency after balloon laceration. TAKE-HOME MESSAGE: Compared with BASILICA (bioprosthetic aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction), UNICORN offers potential advantages, including enhanced leaflet tissue displacement and procedure simplification, minimizing the need for wire exchanges and snare retrieval maneuvers.
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