Left femoral vein access for transcatheter mitral valve interventions in unfavorable interatrial septal anatomy

Catheter Cardiovasc Interv. 2021 Nov 15;98(6):E971-E976. doi: 10.1002/ccd.29950. Epub 2021 Sep 17.

Abstract

Optimal transseptal puncture (TSP) position on the interatrial septum as well as proper catheter direction and maneuverability in the left atrium (LA) are key elements for successful mitral valve (MV) interventions. TSP is usually performed from the right femoral vein being more comfortable for the operator and easier to reach the fossa ovalis. In the cases reported, TSP was performed from left femoral vein (LFV) to improve delivery system maneuverability and trajectory inside the LA in the context of MV repair with MitraClip. According to this early experience, LFV approach might be considered as first choice or as an alternative solution in patients in whom a higher position of the delivery system relative to the mitral annulus is needed.

Keywords: MitraClip; access site management; left femoral vein; mitral valve percutaneous repair; transseptal puncture; vascular access.

Publication types

  • Case Reports

MeSH terms

  • Atrial Septum* / diagnostic imaging
  • Atrial Septum* / surgery
  • Cardiac Catheterization
  • Femoral Vein / diagnostic imaging
  • Humans
  • Mitral Valve* / diagnostic imaging
  • Mitral Valve* / surgery
  • Treatment Outcome