Aortic Valve Trans-Leaflet Lithotripsy for Targeted Periannular Calcium Modification Prior to TAVI.

•Novel technique (ATLAS) using leaflet traversal and intravascular lithotripsy in aortic valve for targeted calcium modification prior to TAVI.•Improve valve expansion and minimize risk of periannular rupture/paravalvular leak.•Self-anchoring at aortic valve leaflet, maintain cardiac output during procedure.•Should be considered in severe eccentric aortic valve calcification.