Key result
Staged TEER reduces tricuspid annular dimensions to enable subsequent TTVR.
Why the study?
Transcatheter tricuspid valve implantation may not be possible when annular size is very large.
Does staged transcatheter edge-to-edge repair facilitate transcatheter tricuspid valve replacement in a patient with severe tricuspid regurgitation and extreme annular enlargement?
Case Report (n=1)
Does staged transcatheter edge-to-edge repair facilitate transcatheter tricuspid valve replacement in a patient with severe tricuspid regurgitation and extreme annular enlargement?
Staged transcatheter edge-to-edge repair can successfully reduce tricuspid annular dimensions to facilitate subsequent transcatheter tricuspid valve replacement in patients with extreme annular enlargement.
Answers are grounded in this paper and cite their sources.
May enable TTVR after annular reduction in extreme enlargement; hypothesis-generating and should not yet change practice.
BACKGROUND: Transcatheter tricuspid valve implantation may not be possible when annular size is very large. CASE SUMMARY: We present an 85-year-old man who developed NYHA functional class III symptoms and recurrent heart failure hospitalizations due to severe tricuspid regurgitation and right ventricular dysfunction. Marked annular enlargement precluded primary transcatheter tricuspid valve replacement. Transcatheter edge-to-edge repair with a PASCAL device achieved partial tricuspid regurgitation reduction and annular remodeling. Follow-up imaging demonstrated reduced annular dimensions, enabling successful staged transcatheter tricuspid valve replacement with a 56-mm EVOQUE valve. DISCUSSION: Severe tricuspid regurgitation with right ventricular dysfunction and extreme annular enlargement is difficult to treat with existing transcatheter therapies. TAKE-HOME MESSAGES: Staged transcatheter edge-to-edge repair-facilitated transcatheter tricuspid valve replacement approach is feasible.
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Jabri et al. (2026) conducted a case report in Severe tricuspid regurgitation and right ventricular dysfunction (n=1). Staged transcatheter edge-to-edge repair (PASCAL) followed by transcatheter tricuspid valve replacement (EVOQUE) was evaluated on Feasibility of staged transcatheter edge-to-edge repair-facilitated transcatheter tricuspid valve replacement. Staged transcatheter edge-to-edge repair with a PASCAL device successfully reduced annular dimensions, enabling subsequent transcatheter tricuspid valve replacement with a 56-mm EVOQUE valve.
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