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. 2017 Jul 26;9(7):574–582. doi: 10.4330/wjc.v9.i7.574

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©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.

Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Pre-close hemostasis technique during a transcatheter aortic valve replacement procedure. A-C: A calcium-free zone is visualized using real time ultrasound and access is obtained using a micropuncture needle system; D-G: The micropuncture system is exchanged for a 180 cm 0.035 wire and the skin tract is sequentially dilated with scalpel, 7 F sheath dilator and later a forceps; H: A Proglide is advanced over the wire into the arterial lumen, and return of pulsatile blood flow confirmed; I and J: After ensuring stable Proglide position, two sequential sutures are deployed at 10 and 2 0’clock; K and L: After the removal of transcatheter aortic valve replacement sheath and guide wire, pre-close sutures are sequentially locked to ensure hemostasis.