Transcatheter tricuspid valve replacement with the EVOQUE valve successfully treated severe tricuspid regurgitation after failed prior interventions, resulting in no residual TR at 1 month.
Case Report (n=1)
Does transcatheter tricuspid valve replacement improve outcomes in a patient with severe tricuspid regurgitation after failed annuloplasty and edge-to-edge repair?
Transcatheter tricuspid valve replacement is a feasible and effective treatment option for severe tricuspid regurgitation even in complex cases with prior failed transcatheter annuloplasty and edge-to-edge repair.
BACKGROUND: The EVOQUE transcatheter tricuspid heart valve (Edwards Lifesciences) is approved for high-risk patients with severe tricuspid regurgitation (TR). This report describes the first EVOQUE implantation after failed percutaneous tricuspid annuloplasty and edge-to-edge repair. CASE SUMMARY: An 80-year-old man with atrial fibrillation underwent percutaneous annuloplasty with a Cardioband (Edwards Lifesciences) for torrential TR. Initially improved, TR recurred within a year, accompanied by severe mitral regurgitation. The patient underwent mitral and tricuspid edge-to-edge repairs, improving symptoms to NYHA functional class II, but TR persisted because of a large coaptation gap. Three years later, TR worsened as a result of single-leaflet device attachment. After multidisciplinary evaluation, transcatheter tricuspid valve replacement (TTVR) with a 48-mm EVOQUE valve was performed successfully. At 1 month, the patient had no residual TR, mild paravalvular leak, and NYHA functional class II status. DISCUSSION: This case highlights TTVR's feasibility for severe TR, even after failed annuloplasty and edge-to-edge repair, thereby expanding options for complex cases. TAKE-HOME MESSAGE: TTVR offers a viable treatment option for complex TR cases even after failed annuloplasty and edge-to-edge repair.
Toggweiler et al. (Tue,) conducted a case report in Severe tricuspid regurgitation (n=1). Transcatheter tricuspid valve replacement (TTVR) with EVOQUE valve was evaluated on Residual TR, paravalvular leak, and NYHA functional class. Transcatheter tricuspid valve replacement with the EVOQUE valve successfully treated severe tricuspid regurgitation after failed prior interventions, resulting in no residual TR at 1 month.