What is the clinical evidence from this study?

Study design: Cohort. Population: Severe tricuspid regurgitation (TR) (n=75). Intervention: Transcatheter tricuspid valve replacement (TTVR) with the EVOQUE system vs. Pre-procedure baseline. Primary outcome: Composite of all-cause death or heart failure hospitalization (HFH) within one year after TTVR.

What question did this study set out to answer?

Evaluate the impact of transcatheter tricuspid valve replacement (TTVR) on heart failure hospitalization (HFH) and clinical outcomes in high-risk patients.

May 3, 2026

Transcatheter Tricuspid Valve Replacement Reduces Heart Failure Hospitalization: Insights from the Canadian Evoque Registry.

Q: What does this research mean for the field?

Transcatheter tricuspid valve replacement yields a 76.1% relative reduction in heart failure hospitalizations and a 6.7% one-year mortality in high-risk patients with severe tricuspid regurgitation. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

Transcatheter tricuspid valve replacement yielded a 76.1% relative reduction in heart failure hospitalizations (p<0.001) and a 6.7% one-year mortality in high-risk patients with severe TR.

Key Points

Evaluate the impact of transcatheter tricuspid valve replacement (TTVR) on heart failure hospitalization (HFH) and clinical outcomes in high-risk patients.
Prospective multicenter registry with 75 high-risk patients undergoing TTVR using the EVOQUE system.
Primary endpoint was a composite of all-cause death or HFH within one year post-TTVR.
Secondary endpoints included annualized HFH rates, symptoms, quality of life, and functional capacity.
76.1% relative reduction in HFH (p<0.001).
NYHA Class III/IV decreased from 76% to 10% (p<0.001).
Significant improvements in six-minute walk distance and KCCQ score (both p<0.001).

Study Design

Type

Cohort (n=75)

Multicenter

Yes

Structured PICO

Does transcatheter tricuspid valve replacement reduce heart failure hospitalization and improve clinical outcomes in high-risk patients with severe tricuspid regurgitation?

Population

75 high-risk patients with severe tricuspid regurgitation (STS score 8.2±5.9%), comprising compassionate-use (n=24) and trial patients (n=51).

Intervention

Transcatheter tricuspid valve replacement (TTVR) with the EVOQUE system.

Comparator

Pre-procedure baseline (annualized HFH rate 12 months before TTVR) / No separate control group.

Outcome

Composite of all-cause death or heart failure hospitalization (HFH) within one year after TTVR.composite

Transcatheter tricuspid valve replacement significantly reduces heart failure hospitalizations and improves functional capacity and quality of life in high-risk patients with severe tricuspid regurgitation.

Abstract

BACKGROUND: Severe tricuspid regurgitation (TR) causes high morbidity and recurrent heart failure hospitalizations (HFH). Transcatheter tricuspid valve replacement (TTVR) consistently eliminates TR, but real-world data on HFH reduction are limited. We therefore evaluated the impact of TTVR on HFH and clinical outcomes in a diverse cohort of compassionate-use and trial patients. METHODS: This prospective, multicenter Canadian registry included 75 high-risk patients (STS score 8.2±5.9%) undergoing TTVR with the EVOQUE system. The primary endpoint was a composite of all-cause death or heart failure hospitalization (HFH) within one year after TTVR. Secondary endpoints included the annualized HFH rate 12 months before vs after TTVR, symptoms, quality of life (KCCQ-Kansas City Cardiomyopathy Questionnaire), and functional capacity. RESULTS: Procedural success was high (technical: 97.3%; device: 93.3%), with sustained TR reduction to ≤mild (94.3%), and a 6.7% one-year mortality. TTVR resulted in an 76.1% relative reduction in HFH (p<0.001). NYHA Class III/IV decreased from 76% to 10% (p<0.001). Significant improvements were observed in six-minute walk distance (260.8±104.7m to 334.5±103.5m, p<0.001) and KCCQ score (56.2±15.2 to 73.5±19.2 points, p=0.001). Multivariable analysis identified baseline NYHA IV (OR 3.96, p=0.003) and prior HFH (OR 2.31, p=0.033) as independent predictors of the composite endpoint (HFH/death). Comparative analysis showed that while compassionate-use patients (n=24) had a higher-risk profile than trial patients (n=51), both cohorts achieved comparable and significant clinical improvements. CONCLUSIONS: In a diverse, high-risk cohort, TTVR dramatically reduced HFH and significantly improved quality of life. These results reinforce the therapeutic benefits of TTVR in high-risk patients with severe TR.

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