Transseptal Access Through Prior Atrial Septal Occluder Device for TMVR for Prosthetic Mitral Valve Degeneration
Recommended Citation
Frisoli TM, Qureshi MA, Giustino G, Dali S, O'Neill BP, Gonzalez PE, Villablanca PA, O'Neill WW, and Lee JC. Transseptal Access Through Prior Atrial Septal Occluder Device for TMVR for Prosthetic Mitral Valve Degeneration. JACC Case Rep 2025;30(32):105373.
Document Type
Article
Publication Date
10-15-2025
Publication Title
JACC Case Rep
Keywords
Cardioform Septal Occluder; septal occluder device; transcatheter mitral valve replacement (TMVR); transseptal access; valve-in-valve
Abstract
BACKGROUND: Transseptal access is critical for transcatheter mitral valve replacement (TMVR), but prior septal occlusion can complicate reinterventions.
CASE SUMMARY: A 62-year-old woman with dyspnea and severe mitral stenosis of a degenerated M3 bioprosthetic valve underwent valve-in-valve TMVR with access achieved through a previously implanted 30-mm Cardioform Septal Occluder using an electrocauterized wire and Brockenbrough needle, followed by balloon dilatations. A 29-mm SAPIEN 3 valve was implanted, reducing the mitral gradient from 19 to 2 mm Hg. A residual left-to-right shunt was left untreated. The patient was discharged the next day without complications.
DISCUSSION: TMVR with a balloon-expandable TAVR platform can be performed safely and effectively through a Cardioform Septal Occluder and is facilitated by predilatation of the Cardioform Septal Occluder with a large balloon.
TAKE-HOME MESSAGE: Transseptal access through a Cardioform Septal Occluder is feasible for valve-in-valve TMVR. Awareness of strategies to manage prior interatrial septum closures is crucial as repeat mitral interventions become more common.
PubMed ID
41106893
Volume
30
Issue
32
First Page
105373
Last Page
105373
