| Summary: | This study presents a case of a successful severed femoral sheath recapture during transfemoral transcatheter aortic valve replacement (TAVR). During skin tunneling with a scalpel, the discontinuity of the femoral sheath occurred. Grasping of the distal sheath with the surgical hemostat was attempted unsuccessfully. A proximal part of the severed sheath was removed and <i>Medtronic Sentrant</i> introducer sheath (14 French) was then placed over the existing <i>Confida</i> wire which permanently remained in position, followed by the introduction of the <i>Amplatz Left 2</i> (AL2) catheter which pushed the severed sheath in the ascending aorta over the <i>Confida</i> wire. The crucial maneuver was the entanglement of the severed sheath in the aortic non-coronary cusp which allowed for its entrapment by the AL2 catheter. This allowed for the coronary guidewire <i>BMW Universal</i> (0.014″) placement and a slow balloon retrieval (<i>SeQuent NEO</i> 2.5 × 25 mm<sup>2</sup>) of the severed sheath into the introducer sheath. The guidewire/balloon catheter was then exchanged for the support wire (0.035″) followed by the removal of the introducer sheath, AL2 catheter and the severed sheath. In conclusion, sheath severing is a complex accidental event during TAVR, which can be solved by intra-aortic recapture and retraction.
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