Covered aortic stent for primary transcaval closure: Case report

Transcaval transcatheter aortic valve replacement (TAVR) is a well-documented alternative access valve implantation method, wherein a large-bore vascular sheath is inserted into the abdominal aorta through the femoral vein and inferior vena cava, resulting in an aorto-caval tract. Closure of this tract is typically accomplished using nitinol occluder devices. In the rare instance that hemostasis is not achieved with a nitinol occluder, covered stents in the aorta are used for bailout. We present a case in which an aortic covered stent was placed as the primary closure strategy in a patient with a very small abdominal aorta that could not accommodate a nitinol occluder device after transcaval TAVR.