Case series of transcatheter tricuspid EVOQUE valve implantation in Spain: clinical experience and early outcomes

ABSTRACT Introduction and objectives: Transcatheter treatment for tricuspid regurgitation (TR) has grown exponentially in recent years. The Edwards EVOQUE system (Edwards Lifesciences, United States), which obtained CE marking in 2023, is a transcatheter tricuspid valve designed to address severe cases of TR that are not amenable to repair using other transcatheter techniques. This study presents the initial experience at our center with the implantation of the EVOQUE tricuspid valve in 10 patients with symptomatic TR. Our objective was to analyze the initial clinical and 30-day imaging follow-up. Methods: We conducted a prospective, single-center observational study. A total of 10 patients with severe TR who underwent EVOQUE tricuspid valve implantation were included. The 30-day early outcomes were evaluated using clinical parameters and echocardiographic findings. We assessed the reduction of TR, right ventricular function, and potential postoperative complications. Results: Ten patients with symptomatic severe TR were included. The median follow-up was 80 days, and the patients' mean age, 77.2 years. The mean TRISCORE was 4.6, and the mean EuroSCORE II, 3.9%. Pacemaker dependance was observed in 40% of patients. The rate of procedural success was 100% according to the Tricuspid Valve Academic Research Consortium criteria. The maximum transprosthetic gradient was 4.8 mmHg. Significant complications included 1 case of severe mitral regurgitation following implantation, 1 complete atrioventricular block, 2 transient right ventricular failures, and 2 prosthetic valve thromboses. The median length of stay was 7 days. Conclusions: The early outcomes of the EVOQUE tricuspid valve implantation are promising, with significant TR reduction and few complications. Further studies are needed to confirm the safety and efficacy profile of the device in the routine clinical practice.