{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T11:15:56Z","timestamp":1784200556068,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"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"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Adults with dextro\u2010transposition of the great arteries (d\u2010TGA) repaired with an atrial switch operation frequently develop systemic atrioventricular valve regurgitation (SAVVR), which is strongly associated with progressive systemic right ventricular (RV) failure and adverse outcomes. Surgical reintervention carries substantial risk in this population, while experience with transcatheter edge\u2010to\u2010edge repair (TEER) remains limited, particularly in atrial\u2010switch anatomy requiring transbaffle access. We report a technically novel strategy using right internal jugular delivery and electrosurgery\u2010assisted transbaffle puncture to facilitate systemic AV valve TEER after Mustard repair when transfemoral access was unsuitable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>We report a 32\u2010year\u2010old man with atrial\u2010switch d\u2010TGA, prior systemic atrioventricular valve annuloplasty, transvenous implantable cardioverter\u2010defibrillator leads, and severe SAVVR causing advanced heart failure. At baseline, he was in NYHA class III, with 6\u2010min walk distance of 290\u2009m and NT\u2010proBNP of 7100\u2009pg\/mL. Preprocedural imaging demonstrated hostile iliofemoral venous anatomy, precluding transfemoral access. A multimodality imaging\u2013guided strategy using right internal jugular venous access and electrosurgery\u2010assisted transbaffle traversal was employed to reach the pulmonary venous atrium. TEER of the systemic AV valve was successfully performed with implantation of two PASCAL ACE devices, resulting in SAVVR reduction from severe to mild without procedural complications or need for inotropic or intravenous vasodilator support. At 6\u2010month follow\u2010up, the patient remained in NYHA class II, 6\u2010min walk distance improved to 365\u2009m, NT\u2010proBNP decreased to 1670\u2009pg\/mL, and SAVVR reduction remained sustained.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>This case demonstrates that SAVV TEER in atrial\u2010switch d\u2010TGA can be performed via a jugular approach using electrosurgery\u2010assisted transbaffle access when transfemoral routes are unsuitable. An anatomy\u2010driven, Heart Team\u2013based approach integrating advanced imaging may expand transcatheter treatment options for highly selected adults with complex congenital heart disease and limited surgical alternatives.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70755","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T10:53:31Z","timestamp":1784199211000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transcatheter Edge\u2010to\u2010Edge Repair of the Systemic AV Valve in Atrial Switch TGA"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7155-9907","authenticated-orcid":false,"given":"Georgios E.","family":"Papadopoulos","sequence":"first","affiliation":[{"name":"Cardiology Department Interbalkan Medical Center Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilias","family":"Ninios","sequence":"additional","affiliation":[{"name":"Cardiology Department Interbalkan Medical Center Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0390-7172","authenticated-orcid":false,"given":"Vlasis","family":"Ninios","sequence":"additional","affiliation":[{"name":"Cardiology Department Interbalkan Medical Center Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.06.020"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.010770"},{"issue":"14","key":"e_1_2_9_4_1","first-page":"e698","article-title":"2018 AHA\/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"139","author":"Stout K. 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