Use of radiofrequency wire and steerable sheath system to streamline workflow for valve-in-valve transcatheter mitral valve replacement

Author(s): Augustin DeLago

Valve-in-valve (ViV) transcatheter mitral valve replacement (TMVR) has emerged as a safer alternative for patients with a degenerated bioprosthesis at high-risk for repeat surgical mitral valve replacement. Precise transseptal puncture (TSP) for ViV-TMVR procedures is critical to ensure access to the mitral valve through the left atrium (LA) for optimal device delivery. The VersaCross steerable system, comprised of a RF transseptal wire and steerable sheath, uses radiofrequency (RF) energy to facilitate controlled TSP, and allows repositioning to optimize the puncture site without needle or guidewire exchanges. This, both, streamlines workflows and reduces potential risks of injury or introducing air. This technique paper aims to describe a more streamlined workflow which can improve safety and access for ViV-TMVR procedures