Internal Jugular Approach for Percutaneous Mitral Paravalvular Leak Closure in a Patient With Interrupted Inferior Vena Cava

Abstract

We report the case of a 48-year-old male with a history of multiple mitral valve replacements and an interrupted inferior vena cava who presented with severe anteroseptal mitral paravalvular leak (PVL). Due to his complex anatomy, standard transfemoral access was not feasible. A right internal jugular vein approach was used to perform a transseptal puncture and successfully deliver five Amplatzer Vascular Plug II devices for PVL closure. The procedure was guided by transesophageal echocardiography and fluoroscopy. Postprocedural imaging confirmed reduced regurgitation and preserved valve function. This case highlights the feasibility and advantages of using the right internal jugular approach for transcatheter PVL closure in patients with challenging venous anatomy.