Successful Transseptal Transcatheter Aortic Valve Replacement With Monitored Anesthesia Care and Standard Delivery System

Transcatheter aortic valve replacement (TAVR) has emerged as a viable treatment option for patients with symptomatic aortic stenosis across all surgical risk groups. Although the need for alternative access to transfemoral access is becoming less frequent due to better device profiles, there is a continued need for such options. Common approaches used today include subclavian, carotid, caval, aortic, or apical. However, the transseptal approach has not been described with the current S3 delivery system. We present, to our knowledge, the first reported case of a transseptal TAVR using the standard delivery system and under monitored anesthesia care (MAC). This case demonstrates that advances in maneuverability and device profile make transseptal delivery of the S3 valve a safe and effective approach in some patients with no other peripheral arterial access.