Direct SVC Access for Valve Replacement With Percutaneous Venotomy Suture System Hemostasis: A Way In.

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.