Loss and recovery of percutaneous femoral access during transcatheter aortic valve replacement. A case report

Abstract

Large bore access vascular closure devices (VCDs) are used to achieve immediate haemostasis after large device percutaneous procedures through the common femoral artery. Such a device or a combination of devices provide early patient ambulation and recovery and avoid surgical complications, however they carry the risk of typical access-related complications seen with percutaneous interventions. In the case of transcatheter aortic valve replacement (TAVR) vascular access complications remain the some of the most common. The MANTA vascular closure device is widely used for access management after TAVR, providing closure for up to 20F or 25F OD devices in the 18F variant. We present a case of loss and restoration of percutaneous femoral arterial access during a TAVR procedure. The necessary guidewire for MANTA deployment was removed mistakenly but was subsequently recovered which enabled successful MANTA deployment afterwards. Postprocedural angiography and ultrasound all revealed successful vessel closure with no access-related complications.

Keywords

• transcatheter aortic valve implantation
• aortic st