ArticleJACC. Case reports2026
UNICORN TAVR in Native Complex Congenital Aortic Stenosis at High Risk of Coronary Obstruction.
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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Abstract
backgroundCoronary artery obstruction is a rare but serious complication of transcatheter aortic valve replacement (TAVR). Undermining iatrogenic coronary obstruction with a radiofrequency needle (UNICORN) is a novel technique of intraleaflet TAVR valve deployment for mitigating this risk. There is limited experience in native aortic valve anatomy, particularly in congenital aortic stenosis. CASE SUMMARY: A 26-year-old man in cardiogenic shock secondary to severe congenital aortic stenosis was successfully treated with emergency TAVR, with leaflet modification using the UNICORN technique due to the high risk of coronary obstruction. DISCUSSION: UNICORN is a novel technique for preventing coronary obstruction in TAVR. Here we describe the first case of UNICORN in congenital aortic stenosis in cardiogenic shock at prohibitive surgical risk. TAKE-HOME MESSAGES: UNICORN can be used successfully in carefully selected native valves at risk of coronary obstruction during TAVR. Use of leaflet modification techniques such as UNICORN enables intervention in a broader cohort of patients unfit for surgery.
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