VA Boston team uses advanced “UNICORN” technique during complex transcatheter aortic valve replacement
Congratulations to VA Boston’s Structural Heart Team on performing a complex TAVR procedure using the UNICORN technique Aug. 25, 2025 — the first time this approach has been used at VA Boston, where it is now available for appropriate Veterans.
Transcatheter aortic valve replacement, or TAVR, offers a minimally invasive way to treat severe aortic valve disease. In some repeat heart valve surgery cases, placing a new valve can push tissue toward the coronary arteries and threaten blood flow. The UNICORN technique — short for Undermining Iatrogenic Coronary Obstruction with Radiofrequency Needle — is an advanced step designed to help keep the coronary arteries open in these high‑risk cases.
“Historically, some patients with prior valves or challenging anatomy had no safe path to valve replacement, because of the high risk of coronary obstruction,” said Dr. Zaid Almarzooq, interventional cardiologist and director of the Structural Heart Program. "By adding the UNICORN technique to our toolbox, we can now offer a minimally invasive option for appropriately selected Veterans."
This first case at VA Boston brought together a multidisciplinary Structural Heart Team, including Almarzooq, Dr. Scott Kinlay, interventional cardiologist and chief of Cardiology, Dr. Jacquelyn Quin, cardiac surgeon, and Dr. Alexander Shapeton, cardiac anesthesiologist, as well as nurse practitioners Sharon LaRose and Torrey Healey, along with cath lab, anesthesia, imaging, and nursing colleagues supporting the Veteran before, during and after the procedure.
“Cases like this show why experience and a true multidisciplinary team matter," said Kinlay. "At VA Boston, interventional cardiology, cardiac surgery, anesthesia, imaging and nursing work side‑by‑side, so we can tackle complex anatomy safely and deliver timely care for our Veterans."