Left Internal Jugular Vein Access for Mitral Transcatheter Edge-to-Edge Repair: A Case Report and Review of Literature for Alternative Venous Access Routes.
Hossameldin Hussein, William Moody, Sagar N Doshi et al.
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Case in brief
A 50-year-old woman with chronic kidney disease and severe functional mitral regurgitation underwent mitral transcatheter edge-to-edge repair (TEER) via left internal jugular vein (IJV) access due to occlusion of the right IJV and inferior vena cava. The procedure utilized the PASCAL system, successfully reducing mitral regurgitation from severe to mild. The patient experienced no complications and remained stable at 2-month follow-up.
What made this case unusual
This case is notable for being the first reported instance of mitral TEER performed via left IJV access, highlighting an alternative route when standard access is compromised.
Diagnostic / clinical pearl
Clinicians should consider left IJV access for mitral TEER in patients with complex venous anatomy or high surgical risk, ensuring thorough pre-procedural imaging and planning.
Why it matters
This case underscores the importance of alternative access routes in high-risk patients, expanding the options available for transcatheter interventions.