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CA LÂM SÀNG Issue: Số 118

Transcatheter aortic valve implantation in patient with small-caliber femoral access by using inline sheath: A case report

Pham Nhat Minh: Hanoi Medical University;
Published: November 28, 2025
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Abstract

Transcatheter Aortic Valve Implantation (TAVI), also commonly known as Transcatheter Aortic Valve Replacement (TAVR), has rapidly become a common intervention for aortic stenosis, particularly in high-risk patients for traditional open-heart surgery. Aortic stenosis, with the aortic valve narrowing that blocks the flow of blood from the heart, could lead to heart failure and death if left untreated.

Initially approved for treatment in elderly patients who have severe comorbidities that could not tolerate surgical valve replacement, transcatheter aortic valve implantation (TAVI) has since expanded its clinical indication. More recent clinical guidelines and studies have established its safety and efficacy even in those patients classified as being at intermediate and low surgical risk. In this regard, TAVI is now being increasingly provided as a safe option compared to surgical aortic valve replacement (SAVR), particularly to elderly patients who prefer a less invasive procedure with a shorter recuperation time.

Numerous studies have explored the efficacy and availability of Transcatheter Aortic Valve Implantation (TAVI) for patients with severe cardiovascular risk. In the current report, we describe a successful case in the instance of a patient whose common femoral artery diameter was less than the conventional minimum level deemed acceptable for TAVI interventions. To overcome this anatomical limitation, we used an inline sheath to enable safe and successful performance of the procedure despite the small vessel size. This case demonstrates the potential for TAVI in patients with small-caliber femoral access, widening the applicability of minimally invasive treatment in anatomy-challenging situations.

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Section CA LÂM SÀNG
Issue Số 118
Pages 159-164