Key result
Percutaneous venotomy suture enables successful superior vena cava access and hemostasis for TPVR.
Why the study?
Adult patients with congenital heart disease often have limited vascular access due to previous procedures and anatomic variations, necessitating novel access approaches for valve replacement.
Case Report (n=1)
A percutaneously placed venotomy suture system enables novel large-bore direct SVC access and safe hemostasis in noncompressible mediastinal sites for complex transcatheter procedures.
May enable direct SVC access with hemostasis in complex congenital cases with limited options; leaves open safety and efficacy in larger cohorts.
BACKGROUND: Adult patients with congenital heart disease often have limited vascular access due to previous procedures and anatomic variations. CASE SUMMARY: This case describes how a percutaneously placed venotomy suture system allowed for direct percutaneous superior vena cava access for delivery sheath insertion for transcatheter pulmonary valve replacement. This system allowed for a novel access approach and the achievement of hemostasis in an otherwise noncompressible site. DISCUSSION: The availability of percutaneously placed venotomy suture placement systems allows for a more daring approach to noncompressible sites within the mediastinum and has the potential to be applied to allow large-bore closed chest access to other mediastinal structures.
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Ghandakly et al. (2026) conducted a case report in Congenital heart disease requiring transcatheter pulmonary valve replacement (n=1). Percutaneously placed venotomy suture system was evaluated on Delivery sheath insertion and achievement of hemostasis in a noncompressible site. A percutaneously placed venotomy suture system successfully enabled direct percutaneous superior vena cava access and hemostasis for transcatheter pulmonary valve replacement.
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