Case Report (n=1)
This case report documents a life-threatening complication of transcatheter tricuspid valve replacement where valve embolization led to the formation of a traumatic ventricular septal defect, highlighting potential flaws in current device designs.
Embolization and traumatic VSD risk with Evoque TTVR warrants caution; leaves open device stability questions beyond early positive reports.
BACKGROUND: Edwards Lifesciences' Evoque valve system is the only approved transcatheter system for tricuspid valve replacement (TTVR). Two major studies have shown remarkable improvements in quality of life after the Evoque valve replacement, and a 2-year follow-up suggested a mortality benefit. CASE SUMMARY: A 64-year-old woman with severe symptomatic tricuspid valve regurgitation underwent implantation of an Evoque valve. Following the procedure, she developed frequent cardiac arrhythmia. Subsequent transthoracic and transesophageal echocardiograms demonstrated valve embolization. Intraoperative observation further revealed that a large ventricular septal defect was created by the displaced valve. DISCUSSION: TTVR carries significant risks; valve migration can result in life-threatening complications, requiring immediate surgical evaluation. This report is the first to document a life-threatening valve embolization, indicating that the valve design remains suboptimal. TAKE-HOME MESSAGES: The current TTVR system design is inadequate. Valve migration is a potentially life-threatening complication that exposes fundamental flaws in the existing device design.
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Aalaei-Andabili et al. (2026) conducted a case report in Severe symptomatic tricuspid valve regurgitation (n=1). Evoque transcatheter tricuspid valve replacement was evaluated on Valve embolization and ventricular septal defect formation.
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