ArticleJACC. Case reports2026
Left Atrial Appendage Closure Via Transhepatic Access in a Patient With Congenitally Interrupted Inferior Vena Cava.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
backgroundLeft atrial appendage occlusion (LAAO) is indicated for patients with nonvalvular atrial fibrillation at risk of thromboembolic stroke and intolerant to long-term anticoagulation. Standard procedural access for LAAO is from the transfemoral approach. In certain circumstances where this is prohibitive, options are limited. CASE SUMMARY: A patient with atrial fibrillation underwent unsuccessful LAAO due to interrupted inferior vena cava (IVC). She was referred for consideration of LAAO via an alternative access. Using a transhepatic approach, she underwent successful occlusion with a 31-mm Watchman FLX Pro device. DISCUSSION: Although rare, transfemoral venous approach can be prohibitive for several reasons, including congenitally absent IVC, occluded IVC filter, or extrinsic compression. This case highlights the preprocedural planning, technical approach, and postprocedural considerations for successful LAAO using a transhepatic approach. TAKE-HOME MESSAGE: Alternate access via a transhepatic approach can be a viable alternative for LAAO when the standard femoral venous approach is prohibitive.
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