Intraprocedural Transesophageal Echocardiography Ensures Accurate Anchoring During Transcatheter Intervention for...

This case report elucidates the indispensable role of structured transesophageal echocardiography imaging in guiding the implantation of the JenaValve, a transcatheter device designed for severe native aortic regurgitation via its unique locator-based anchoring system.

First, use the midesophageal aortic valve short-axis view to confirm capture of the left and noncoronary cusps. Second, employ a modified transgastric aortic valve short-axis 90° view to visualize the often obscured right coronary cusp. These complementary views can verify precise locator engagement on all 3 leaflets before final deployment.

Overreliance on fluoroscopy can lead to valve malposition or migration due to poor cusp visualization. Excessive manipulation during positioning can dislodge locators into the left ventricular outflow tract.

A systematic, multiview transesophageal echocardiography approach is critical to confirm successful leaflet capture and ensure stable JenaValve deployment in noncalcified structures, mitigating major risks of device failure.