Transjugular Tricuspid Edge-to-Edge Repair for Hostile Inferior Vena Cava Anatomy.

Authors

Gioel Gabrio Secco, Edoardo Elia, Chiara Sartori, Giulia Maj, Marco Lombardi, Andrea Audo, Giuseppe Patti

Published in

JACC. Case reports. Pages 109420. Aug 04, 2026. Epub Aug 04, 2026.

Abstract

To describe a step-by-step transjugular approach for tricuspid transcatheter edge-to-edge repair (T-TEER) when hostile inferior vena cava anatomy precludes safe transfemoral access.
We describe a case transjugular T-TEER in a patient with severe tricuspid regurgitation and prohibitive inferior vena cava anatomy. Distal right jugular access was obtained under ultrasound guidance with preclosure. Progressive dilation allowed advancement of the guiding catheter over stiff guidewire. Navigation toward tricuspid valve required awareness of reversed catheter movements to maintain orientation. Two devices were implanted in the anteroseptal position under echocardiographic guidance, using the first clip as landmark for the second one. The system was straightened before withdrawal.
Large-bore jugular access may increase risk of vascular complications; distal puncture and gradual dilation are essential. Reversed catheter movements may cause disorientation or interaction with atrial structures.
Transjugular access represents a feasible alternative for T-TEER when transfemoral delivery is unsafe.

PMID:
42554558
Bibliographic data and abstract were imported from PubMed on 05 Aug 2026.

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