https://doi.org/10.1007/s00392-025-02625-4
1Universitätsklinikum Schleswig-Holstein Medizinische Klinik II / Kardiologie, Angiologie, Intensivmedizin Lübeck, Deutschland; 2Asklepios Westklinikum Rissen Abteilung für Kardiologie Hamburg, Deutschland
A 79-year-old patient with a history of recurrent cardiac decompensation, presenting with peripheral edema and dyspnea, was managed following an unsuccessful edge-to-edge tricuspid valve repair (performed in January 2024), which did not achieve satisfactory reduction of tricuspid regurgitation (TR). The patient previously underwent successful mitral edge-to-edge repair in 2020, resulting in only trace mitral regurgitation, and had a two-chamber pacemaker because of sick sinus syndrome.
Despite prior interventions, the patient continued to experience severe TR and chronic right heart failure, warranting the decision to perform transcatheter tricuspid valve replacement (TTVR) using an EVOQUE tricuspid prosthesis. The procedure was successful, with only trace valvular regurgitation observed post-implantation (no paravalvular leakage). The patient’s postoperative course was uneventful, and no episodes of cardiac decompensation occurred during the two-month follow-up period.
Two months post-implantation, the patient demonstrated an improved quality of life and was reclassified as NYHA class I, reflecting a notable improvement in heart failure symptoms.
Conclusion:
TTVR is a feasible and effective intervention in selected patients with suitable anatomy and persistent severe TR following prior edge-to-edge repair. The positive outcome observed in this case supports the use of TTVR in similar clinical scenarios.