Today, we successfully performed our first implantation of the Aveir VR device via right jugular access.

In our center, among the 37 patients who received the Aveir VR implantation, there were 3 instances (approximately 8% of cases) where crossing the tricuspid valve via femoral access proved impossible. The use of a snare did not facilitate the implantation attempt in any of these three patients. In the first two cases, we opted to proceed with transvenous pacemaker implantation.

Our experience indicates that the primary factor contributing to the failure of the femoral approach is not the size of the tricuspid annulus (as we have successfully implanted devices in considerably smaller valves). Rather, the determining factor appears to be the anatomical angle between the vena cava and the right atrium, as well as the presence of the Eustachian valve.

Stefano Guarracini Michele Di Mauro Andrea Italiano
Thanks to Abbott for the support! Stefano Speranza