Work

Novel Use of Radiofrequency Guidewire in Leaflet Modification

Year: 2026

Type: article

Abstract: OBJECTIVE: Leaflet modification techniques are increasingly used in transcatheter valve interventions to prevent complications such as coronary artery obstruction and left ventricular outflow tract obstruction. We present 2 cases illustrating novel use of the PowerWire Pro guidewire (Baylis Medical Technologies) for successful leaflet traversal. KEY STEPS: 1) Determine optimal angle for leaflet traversal; 2) position the PowerWire Pro at the base of the target leaflet; 3) traverse the leaflet using the PowerWire and electrocautery; and 4) perforate the leaflet using serial balloon dilatations. POTENTIAL PITFALLS: Higher tip load may lead to complications if perforation in suboptimal location; traversal of a calcified leaflet may be more difficult with a larger wire. TAKE-HOME MESSAGE: The use of the Baylis PowerWire Pro guidewire for leaflet modification is a novel technique that has potential advantages over the commonly used Asahi Astato wire, including fewer equipment exchanges, added support for catheter delivery, and increased push ability for easier leaflet traversal.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2026.106921

Authors: Ryan Cooney, Sneha Vakamudi, Joshua Grimm, Jose Condado, Mark Pirwitz, Mark Gajjar

Institutions: Ascension, Seton Medical Center Austin, Baylor Scott & White Health

Language: English

Topic: Cardiac Valve Diseases and Treatments

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850