{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:19:50Z","timestamp":1788268790558,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The increasing indications of transcatheter edge\u2010to\u2010edge repair (TEER) have led to its use in more diverse populations, including patients with complex comorbidities where standard transfemoral access may not be feasible. In these cases, utilizing the right internal jugular vein (IJV) access has been reported as a safe and practical alternative route. Herein, we report the first case of mitral TEER via left IJV access, using PASCAL system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 50\u2010year\u2010old woman with long\u2010standing chronic kidney disease and two previously failed renal transplants suffered repeated admissions for acute pulmonary edema. Echocardiography confirmed severe functional mitral regurgitation (MR) and global left ventricular systolic dysfunction. Due to extremely high surgical risk, the multidisciplinary heart team opted for mitral TEER. Unexpectedly, pre\u2010procedural imaging demonstrated complete occlusion of the inferior vena cava with prominent collateral circulation and total occlusion of the right IJV. After extensive team discussion, access via the left IJV was selected. Transseptal puncture (TSP) was performed with the VersaCross radiofrequency system, the septum was dilated using a 6\u2009mm Mustang balloon, and a PASCAL P10 device was successfully implanted between the A2 and P2 segments, resulting in reduction of MR severity from severe (4+) to mild (1+). The procedure concluded without complications and hemostasis was secured. At 2\u2010month follow\u2010up the patient remained stable with no recurrent decompensations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Left IJV is a feasible alternative access for mitral\u2010TEER when other venous accesses are not feasible. Proper pre\u2010procedural planning and local expertise is essential to overcome the technical challenges related to TSP and steering the guiding catheter against the complex anatomical orientation of the left innominate vein.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70727","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T12:07:42Z","timestamp":1783944462000},"page":"1052-1063","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Left Internal Jugular Vein Access for Mitral Transcatheter Edge\u2010to\u2010Edge Repair: A Case Report and Review of Literature for Alternative Venous Access Routes"],"prefix":"10.1002","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4763-4011","authenticated-orcid":false,"given":"Hossameldin","family":"Hussein","sequence":"first","affiliation":[{"name":"Department of Cardiology Queen Elizabeth University Hospital Birmingham UK"},{"name":"Department of Cardiology, Kasr Al\u2010Ainy Medical School Cairo University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Moody","sequence":"additional","affiliation":[{"name":"Institute for Cardiovascular Sciences, College of Medical and Dental Sciences University of Birmingham Birmingham UK"},{"name":"Department of Cardiology University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sagar N.","family":"Doshi","sequence":"additional","affiliation":[{"name":"Institute for Cardiovascular Sciences, College of Medical and Dental Sciences University of Birmingham Birmingham UK"},{"name":"Department of Cardiology University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adnan","family":"Nadir","sequence":"additional","affiliation":[{"name":"Institute for Cardiovascular 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