CTICasesTranscaval Transcatheter Aortic Valve Replacement (TAVR)
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Imaging findings
Fluoroscopy and angiographic series demonstrate the placement of an aortic valve via a transcaval approach. Access is gained through the femoral vein into the inferior vena cava (IVC), followed by a transcaval puncture directly into the abdominal aorta. A large sheath is passed from the IVC into the aorta to deploy the TAVR, and the transcaval fistula is subsequently closed using an Amplatzer duct occluder plug.
Key takeaways
Transcaval TAVR is an innovative, investigational access route for transcatheter aortic valve replacement in patients with severe peripheral arterial disease who lack adequate iliofemoral, transapical, or transcortical access. This approach involves creating a temporary arteriovenous fistula between the abdominal aorta and IVC, which is successfully closed with an occluding device at the end of the procedure.
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