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BASILICA Procedure in Toledo, Ohio: Advancing Structural Heart Care for High-Risk Patients

11 hours ago
4 min read

For patients in Toledo, Northwest Ohio, and the surrounding communities of Maumee, Perrysburg, Sylvania, and beyond, access to advanced structural heart care has never been more important. Toledo Cardiology is proud to offer the BASILICA procedure, a specialized technique that is expanding treatment options for patients who face elevated risk during transcatheter valve procedures. If you or someone you love has been told that a valve condition is complex or high-risk, understanding this innovation could open a door that was previously closed.

WHAT IS THE BASILICA PROCEDURE?

BASILICA stands for Bioprosthetic or Native Aortic Scallop Intentional Laceration to Prevent Coronary Artery Obstruction. The name describes exactly what the technique does. A cardiologist uses a precise, minimally invasive approach to split a portion of a valve leaflet (the thin, movable flap of tissue that opens and closes to regulate blood flow) before a new valve is placed. This deliberate laceration (controlled cut) creates a pathway that allows blood to continue flowing freely into the coronary arteries (the vessels that supply the heart muscle itself with oxygen-rich blood).

Without this step, certain patients undergoing transcatheter valve replacement (a catheter-based procedure that delivers a new valve through blood vessels rather than open-chest surgery) face a serious risk: the new valve can physically displace the old valve leaflet and block the openings to the coronary arteries. That complication, called coronary artery obstruction, can be life-threatening. BASILICA is specifically designed to prevent it.

WHY THE MECHANISM MATTERS FOR PATIENT OUTCOMES

The physiological concern here is direct. The coronary arteries branch off the aorta (the body's main artery) just above the aortic valve (the valve between the heart's main pumping chamber and the aorta). When a transcatheter valve is deployed, it pushes outward against the existing valve structure. In patients with certain anatomical configurations, including those who have already had a surgical valve replacement, the displaced leaflet material can migrate toward those coronary artery openings and restrict or block flow entirely.

Ischemia (reduced blood flow to the heart muscle) caused by sudden coronary obstruction is a critical event. By intentionally splitting the at-risk leaflet tissue before valve deployment, BASILICA redirects that tissue away from the coronary openings, preserving perfusion (blood delivery) to the heart muscle throughout and after the procedure. The result is a meaningfully safer pathway through an otherwise prohibitive intervention.

This is the same category of innovation that drives our TAVR program in Toledo, where our team has already achieved milestones for the region. Complex structural heart care is not a distant, big-city-only resource for Northwest Ohio patients.

WHO MAY BENEFIT FROM BASILICA

Not every valve patient requires BASILICA. The technique is reserved for cases where coronary obstruction risk is identified in advance through careful imaging and anatomical review. Patients who may benefit include those with:

Complex aortic valve disease (disease of the valve between the heart's left ventricle and the aorta) requiring transcatheter replacement
Prior surgical bioprosthetic valve replacement (a valve made from biological tissue implanted through open-heart surgery) who now need a valve-in-valve procedure
Anatomical features such as low coronary artery height or a narrow aortic root (the base of the aorta where it meets the heart) that increase obstruction risk
Elevated surgical risk that makes open-heart reoperation dangerous

Managing these overlapping risk factors requires the kind of individualized, team-based evaluation that Toledo Cardiology provides. For patients managing additional cardiovascular conditions alongside valve disease, you may also find our overview of peripheral artery disease treatment in Toledo relevant, as vascular disease and structural heart disease frequently coexist.

BASILICA AT TOLEDO CARDIOLOGY: A LOCAL MILESTONE

The BASILICA procedure has been performed at Toledo Cardiology by Drs. Noman, Taleb, DiBardino, and S. Alo, working alongside the Cath Lab team at Mercy Health St. Vincent Medical Center in Toledo. Bringing this level of structural heart innovation to Northwest Ohio means that patients in Toledo, Findlay, Bowling Green, and the southeast Michigan border region do not need to travel to distant academic centers for complex valve care. Our structural heart team evaluates each patient's anatomy, history, and risk profile to determine whether BASILICA or another advanced approach is appropriate.

Comprehensive heart health also means addressing the upstream factors that contribute to valve and coronary disease. Our posts on women and heart disease symptoms in Toledo and related cardiovascular risk offer a broader picture of prevention alongside treatment.

Schedule Your Appointment in Toledo

If you or a loved one has been told that a valve procedure carries elevated risk due to anatomy or prior heart surgery, a consultation with Toledo Cardiology's structural heart team is the right next step. Our office serves patients throughout Toledo, Northwest Ohio, and the surrounding region. When you call, our staff can help you understand what to bring to your first appointment and direct you to parking at our facilities.