Evidence map›Paper›PMID 42331407›Full record

ArticleJACC. Cardiovascular interventions2026

UNICORN During Transcatheter Aortic Valve Replacement in Native and Bioprosthetic Aortic Valves: A Multicenter Study.

Elsa Hebbo, John T D'Angelo, Anton Camaj, Anas T Noman, Hiroki A Ueyama, Liana T Alcaro, Roger J Laham, Gennaro Giustino, Mostafa Naguib, Adnan M Halboni and 14 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Cardiovascular interventions, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Elsa HebboEmory University Hospital Midtown, Atlanta, Georgia, USA.
John T D'AngeloEmory University Hospital Midtown, Atlanta, Georgia, USA.
Anton CamajMount Sinai Fuster Heart Hospital, New York, New York, USA.
Anas T NomanEmory University Hospital Midtown, Atlanta, Georgia, USA.
Hiroki A UeyamaEmory University Hospital Midtown, Atlanta, Georgia, USA.
Liana T AlcaroEmory University Hospital Midtown, Atlanta, Georgia, USA.
Roger J LahamBeth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Gennaro GiustinoAtlantic Health System, Morristown, New Jersey, USA.
Mostafa NaguibAtlantic Health System, Morristown, New Jersey, USA.
Adnan M HalboniHenry Ford Hospital, Detroit, Michigan, USA.
Pedro A VillablancaHenry Ford Hospital, Detroit, Michigan, USA.
David J Hildick-SmithUniversity Hospitals Sussex NHS Foundation Trust, Brighton and Hove, United Kingdom.
John T SaxonUVA Health, Charlottesville, Virginia, USA.
Jaffar M KhanNational Institutes of Health, National Heart Lung and Blood Institute, Division of Intramural Research, Bethesda, Maryland, USA.
Toby RogersMedStar Washington Hospital Center, Washington, District of Columbia, USA.
Andrei M PopAscension Alexian Brothers Medical Center, Elk Grove Village, Illinois, USA.
Yousif AhmadUniversity of California, San Francisco, San Francisco, California, USA.
Patrick T GleasonEmory University Hospital Midtown, Atlanta, Georgia, USA.
John C LiskoEmory University Hospital Midtown, Atlanta, Georgia, USA.
Nikoloz ShekiladzeEmory University Hospital Midtown, Atlanta, Georgia, USA.
Robert J LedermanNational Institutes of Health, National Heart Lung and Blood Institute, Division of Intramural Research, Bethesda, Maryland, USA.
Adam B GreenbaumEmory University Hospital Midtown, Atlanta, Georgia, USA.
Vasilis C BabaliarosEmory University Hospital Midtown, Atlanta, Georgia, USA.
Isida BykuEmory University Hospital Midtown, Atlanta, Georgia, USA. Electronic address: isida.byku@emory.edu.

Funding

Novel catheter treatment of valve diseaseZIAHL006040 · NHLBI · NATIONAL HEART, LUNG, AND BLOOD INSTITUTE · PI LEDERMAN, ROBERT J · 2010 to 2025
$23.6M
Intramural NIH HHS ZIA HL006040
6 · The paper itself

Abstract

backgroundUNICORN (undermining coronary obstruction with radiofrequency "needle") has been adopted by some operators to prevent coronary obstruction during transcatheter aortic valve replacement (TAVR). More clinical data are needed to evaluate UNICORN outcomes.

objectivesThe aim of this study is to describe preliminary outcomes of UNICORN during TAVR.

methodsNine sites contributed consecutive patients undergoing UNICORN TAVR from March 2024 to May 2025. Primary success was UNICORN TAVR without composite periprocedural coronary obstruction, reintervention, or death. Primary safety endpoints were intraprocedural hypotension plus overall 30-day safety, which included 30-day death, stroke, coronary obstruction requiring reintervention, stage 3 or 4 acute kidney injury, life-threatening bleeding, major vascular complication, and valve-related reintervention. Two UNICORN techniques, intraleaflet deployment and full-leaflet tearing, were used.

resultsFifty-three patients (8 native aortic valves, 30 surgical valves, and 15 transcatheter valves) were included. Left-sided and right-sided UNICORN procedures were performed in 30 (57%) and 19 (36%), respectively. UNICORN was bilateral in 4 (8%). Eleven (21%) underwent contralateral BASILICA (bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction), and 3 (6%) received contralateral snorkel-stent protection. Forty patients (76%) underwent intraleaflet deployment, and 13 (24%) underwent full-leaflet tearing. Primary success occurred in 51 patients (96%). Two (4%) experienced coronary obstruction and required rescue percutaneous coronary intervention. Overall 30-day safety was observed in 46 patients (87%), with strokes in 3 (6%), life-threatening bleeding in 2 (4%), and major vascular complications in 2 (4%). Intraprocedural hypotension occurred in 12 (23%). There were no deaths, valve-related reinterventions, or stage 3 to 4 acute kidney injury at 30 days.

conclusionsUNICORN during TAVR was successful in preventing coronary obstruction. Intraprocedural hypotension requiring vasopressor support was frequent. UNICORN should be considered in cases in which lower risk options are unlikely to be successful.

Indexed as

Aortic ValveAortic Valve StenosisBioprosthesisCoronary StenosisHeart Valve ProsthesisTranscatheter Aortic Valve ReplacementAgedAged, 80 and overFemaleHumansMaleProsthesis DesignRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeBASILICAcoronary occlusion/prevention and control/etiology/diagnostic imaging/physiopathologyiatrogenic disease/prevention and controltranscatheter aortic valve replacement/adverse effects/instrumentation

Identifiers

PMID42331407
PMCPMC13356907

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.