4-Dimensional Intracardiac Echocardiography-Guided Antegrade TAVR Using a Novel CABLE-TAVR Technique
Document Type
Article
Publication Date
5-13-2026
Publication Title
JACC Case Reports
Abstract
Background: An antegrade approach to transcatheter aortic valve replacement (TAVR) has become less common because of the complexity and chance of complication, but use of a large-bore sheath to protect the mitral valve has been described. Case Summary: We present a 75-year-old patient with severe symptomatic aortic stenosis who underwent antegrade TAVR with 4-dimensional intracardiac echocardiography under conscious sedation. We describe a novel technique using an Edwards Commander Delivery System to flex a large-bore sheath across the mitral valve to protect the atrial septum and mitral valve during valve delivery. Discussion: Patients with limited vascular access for retrograde TAVR and who are not candidates for general anesthesia owing to pulmonary disease can undergo antegrade TAVR under conscious sedation and 4-dimensional intracardiac echocardiography guidance. Take-Home Message: Our case illustrates an antegrade approach with a novel technique that may be a suitable alternative to TAVR in high-risk patients who otherwise would not be candidates for aortic valve replacement.
PubMed ID
42126377
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Robin, Kaleb J.; Campbell, Joshua M.; and Castellanos, Jorge A., "4-Dimensional Intracardiac Echocardiography-Guided Antegrade TAVR Using a Novel CABLE-TAVR Technique" (2026). School of Medicine Faculty Publications. 4706.
https://digitalscholar.lsuhsc.edu/som_facpubs/4706
10.1016/j.jaccas.2026.108156