Toggle Malapposition and Femoral Subocclusion as a Potential Complication of Manta Closure Device During TAVR.

: A 73-year-old woman with severe aortic stenosis underwent successful TAVR implantation through the right femoral artery. Femoral closure was intended with the new collagen-based 14 Fr Manta device; after apparent successful closure, control angiography showed mobile subocclusive intravascular material protruding from the anterior puncture site to the posterior calcified wall. To the best of our knowledge, this is the first report of this specific complication using the Manta closure device, highlighting the importance of accurate device positioning before collagen deployment.