An Unusual Femoral Sheath Severing with Successful Recapture: A Case Report
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 attempte...
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| Language: | English |
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MDPI AG
2021-10-01
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| Online Access: | https://www.mdpi.com/2571-841X/4/4/34 |
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| author | Frane Runjić Andrija Matetic Matjaž Bunc Nikola Crnčević Ivica Kristić |
| author_facet | Frane Runjić Andrija Matetic Matjaž Bunc Nikola Crnčević Ivica Kristić |
| author_sort | Frane Runjić |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-10T03:10:53Z |
| format | Article |
| id | doaj.art-b1dbc505b7854a7e823471cadda41571 |
| institution | Directory Open Access Journal |
| issn | 2571-841X |
| language | English |
| last_indexed | 2024-03-10T03:10:53Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Reports |
| spelling | doaj.art-b1dbc505b7854a7e823471cadda415712023-11-23T10:26:03ZengMDPI AGReports2571-841X2021-10-01443410.3390/reports4040034An Unusual Femoral Sheath Severing with Successful Recapture: A Case ReportFrane Runjić0Andrija Matetic1Matjaž Bunc2Nikola Crnčević3Ivica Kristić4Department of Cardiology, University Hospital of Split, Spinčićeva 1, 21000 Split, CroatiaDepartment of Cardiology, University Hospital of Split, Spinčićeva 1, 21000 Split, CroatiaDepartment of Cardiology, Ljubljana University Medical Centre, Zaloska Cesta 7, 1000 Ljubljana, SloveniaDepartment of Cardiology, University Hospital of Split, Spinčićeva 1, 21000 Split, CroatiaDepartment of Cardiology, University Hospital of Split, Spinčićeva 1, 21000 Split, CroatiaThis 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.https://www.mdpi.com/2571-841X/4/4/34accidental eventsvascular accesssheath severing |
| spellingShingle | Frane Runjić Andrija Matetic Matjaž Bunc Nikola Crnčević Ivica Kristić An Unusual Femoral Sheath Severing with Successful Recapture: A Case Report Reports accidental events vascular access sheath severing |
| title | An Unusual Femoral Sheath Severing with Successful Recapture: A Case Report |
| title_full | An Unusual Femoral Sheath Severing with Successful Recapture: A Case Report |
| title_fullStr | An Unusual Femoral Sheath Severing with Successful Recapture: A Case Report |
| title_full_unstemmed | An Unusual Femoral Sheath Severing with Successful Recapture: A Case Report |
| title_short | An Unusual Femoral Sheath Severing with Successful Recapture: A Case Report |
| title_sort | unusual femoral sheath severing with successful recapture a case report |
| topic | accidental events vascular access sheath severing |
| url | https://www.mdpi.com/2571-841X/4/4/34 |
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