{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T07:40:17Z","timestamp":1792395617750,"version":"4.4.0"},"reference-count":10,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"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:p>\n                    Systemic atrioventricular valve (SAVV) regurgitation contributes importantly to systemic right ventricular deterioration in adults with congenitally corrected transposition of the great arteries (ccTGA) and dextro\u2010transposition of the great arteries (\n                    <jats:sc>d<\/jats:sc>\n                    \u2010TGA) after atrial\u2010switch repair. Transcatheter edge\u2010to\u2010edge repair (TEER) has emerged as an option for selected patients at high or prohibitive surgical risk, and prior congenital series have established the feasibility of transseptal, transbaffle, and alternative access strategies. However, procedural execution remains highly anatomy\u2010dependent because systemic venous pathways, atrial baffles, ventricular topology, cardiac orientation, and access\u2010to\u2010valve geometry can substantially alter guide\u2010catheter support and device coaxiality. We report a single\u2010center Interventional Rounds experience of four consecutive high\u2010risk adults undergoing SAVV\u2010TEER across four distinct transposition anatomies: ccTGA with dextrocardia,\n                    <jats:sc>d<\/jats:sc>\n                    \u2010TGA after Mustard atrial\u2010switch repair, Mustard anatomy with severe iliofemoral tortuosity, and ccTGA with interrupted inferior vena cava and azygos continuation. Transfemoral access was used in two patients, and right internal jugular access in two. Three procedures were performed with PASCAL ACE and one with MitraClip. Device implantation was successful in all four patients, with SAVV regurgitation reduced from severe (3+) to mild (1+). Final mean SAVV gradients were 1.5, 2.1, 1.9, and 1.8\u2009mmHg, respectively, and no major acute procedural complications occurred. The principal technical message is that access selection should be guided not only by anatomic patency but by the anticipated mechanical trajectory of the delivery system. Right internal jugular access may be selected prospectively as the preferred primary route when inferior venous anatomy is absent or expected to provide unfavorable curvature, support, or device alignment. Dextrocardia and atrial\u2010switch baffle anatomy may additionally require specific steering and traversal adaptations. These observations represent focused procedural refinements within the evolving congenital TEER experience rather than evidence of comparative efficacy or safety.\n                  <\/jats:p>","DOI":"10.1002\/ccd.70953","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T06:47:38Z","timestamp":1792392458000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anatomy\u2010Driven Transcatheter Edge\u2010to\u2010Edge Repair of the Systemic Atrioventricular Valve in Complex Transposition Anatomy"],"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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4444-3781","authenticated-orcid":false,"given":"Ilias","family":"Ninios","sequence":"additional","affiliation":[{"name":"Cardiology Department Interbalkan Medical Center Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8381-8200","authenticated-orcid":false,"given":"Alexandra","family":"Frogoudaki","sequence":"additional","affiliation":[{"name":"2<sup>nd<\/sup> Cardiology Department, Attikon University Hospital National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7491-6319","authenticated-orcid":false,"given":"George","family":"Giannakoulas","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, AHEPA University Hospital Aristotle University of Thessaloniki 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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7406-5427","authenticated-orcid":false,"given":"Grigorios","family":"Giamouzis","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital of Larissa, Faculty of Medicine University of Thessaly Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,18]]},"reference":[{"issue":"22","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"2259","DOI":"10.1016\/j.jacc.2021.08.083","article-title":"Interventions for Congenital Atrioventricular Valve Dysfunction","volume":"79","author":"Barry O. M.","year":"2022","journal-title":"Journal of the American College of Cardiology"},{"issue":"10","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.122.025628","article-title":"Percutaneous Edge\u2010to\u2010Edge Repair for Systemic Atrioventricular Valve Regurgitation in Patients With Congenital Heart Disease: The First Descriptive Cohort","volume":"11","author":"Guerin P.","year":"2022","journal-title":"Journal of the American Heart Association"},{"issue":"4","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.yjcafi.2025.10.009","article-title":"Heart Failure Management in the Adult Congenital Heart Disease Patient: Part II: Nonpharmacological Therapies","volume":"2","author":"Ortega\u2010Legaspi J. M.","year":"2025","journal-title":"Journal of Cardiac Failure\u2010Intersections"},{"issue":"2","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1002\/ccd.30935","article-title":"Introduction of Transcatheter Edge\u2010to\u2010Edge Repair in Patients With Congenital Heart Disease at a Children's Hospital","volume":"103","author":"Jolley M. A.","year":"2024","journal-title":"Catheterization and Cardiovascular Interventions"},{"issue":"9","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"744","DOI":"10.4244\/EIJ-D-20-01093","article-title":"Transcatheter Valve Repair in Congenitally Corrected Transposition of the Great Arteries","volume":"17","author":"Ott I.","year":"2021","journal-title":"EuroIntervention"},{"issue":"1","key":"e_1_2_10_7_1","article-title":"Percutaneous Edge\u2010to\u2010Edge Repair of Atrioventricular Valves in Congenital Heart Disease","volume":"5","author":"Perl L.","year":"2026","journal-title":"JACC: Advances"},{"issue":"14","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"4798","DOI":"10.3390\/jcm12144798","article-title":"Catheter\u2010Based Techniques for Addressing Atrioventricular Valve Regurgitation in Adult Congenital Heart Disease Patients: A Descriptive Cohort","volume":"12","author":"El Bouziani A.","year":"2023","journal-title":"Journal of Clinical Medicine"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijcchd.2022.100370","article-title":"Percutaneous Edge\u2010to\u2010Edge Repair in Congenital Heart Disease: Preliminary Results of a Promising New Technique","volume":"8","author":"Silini A.","year":"2022","journal-title":"International Journal of Cardiology Congenital Heart Disease"},{"issue":"17","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1016\/j.jacc.2023.08.008","article-title":"Tricuspid Valve Academic Research Consortium Definitions for Tricuspid Regurgitation and Trial Endpoints","volume":"82","author":"Hahn R. T.","year":"2023","journal-title":"Journal of the American College of Cardiology"},{"key":"e_1_2_10_11_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.crmic.2025.100086","article-title":"Transcatheter Edge\u2010to\u2010Edge Repair of the Systemic Atrioventricular Valve in a Patient With Congenitally Corrected Transposition of the Great Arteries and Dextrocardia","volume":"8","author":"Papadopoulos G. E.","year":"2025","journal-title":"Cardiovascular Revascularization Medicine: Interesting Cases"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70953","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.70953","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70953","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T06:47:40Z","timestamp":1792392460000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.70953"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,18]]},"references-count":10,"alternative-id":["10.1002\/ccd.70953"],"URL":"https:\/\/doi.org\/10.1002\/ccd.70953","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,18]]},"assertion":[{"value":"2026-05-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ccd.70953"}}