Related Experiment Video
Updated: Oct 14, 2025
Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Achieving Hemostasis Posttranscatheter Aortic Valve Replacement in a Patient with Aortobifemoral Bypass Graft Using
Ebubechukwu Ezeh1, Mohammad Amro2, Esiemoghie Akhigbe1
1Internal Medicine Department, Marshall University, Huntington WV, USA.
Insights
Transcatheter aortic valve replacement (TAVR) in patients with aortobifemoral bypass grafts is challenging. Direct graft puncture with Perclose closure offers a viable hemostasis solution for transfemoral TAVR.
Area of Science:
- Cardiovascular Interventions
- Vascular Surgery
Background:
- Aortobifemoral bypass grafts complicate vascular access for percutaneous interventions.
- Transcatheter aortic valve replacement (TAVR) access is challenging in these patients, often due to comorbidities like peripheral artery disease.
Observation:
- Preoperative planning is crucial to select suitable access sites.
- A case report details TAVR in a patient with an aortobifemoral bypass graft.
Findings:
- Direct puncture of the aortobifemoral bypass graft was performed for transfemoral TAVR.
- The Perclose device was successfully used to achieve hemostasis after graft puncture.
Implications:
- This approach demonstrates that Perclose closure can be a viable option for managing vascular access in complex TAVR cases.
- It highlights the importance of considering direct graft puncture and advanced closure techniques when standard access is limited.
Abstract:
The presence of aortobifemoral bypass graft can complicate vascular access during percutaneous intervention. Choosing an access route for transcatheter aortic valve replacement (TAVR) in this patient population can be challenging. Access options are further limited by the presence of coexisting vascular comorbidities such as extensive peripheral artery diseases in these patients. Adequate preoperative planning to determine the suitability of different access sites is, therefore, very crucial. Our case report shows that the use of Perclose can be a viable option for achieving hemostasis after a direct puncture of an aortobifemoral bypass graft during transfemoral TAVR.
