Early Experience With Evoque Transcatheter Tricuspid Valve Replacement in Carcinoid Heart Disease

Tricuspid regurgitation (TR) is nearly universal in carcinoid heart disease (CHD), but surgical replacement carries significant risk, and CHD was excluded from the landmark TRISCEND II trial. We present seven patients with CHD undergoing Evoque transcatheter tricuspid valve replacement (TTVR) at two tertiary centers. All achieved procedural success with TR reduced to mild or less and NYHA improvement at median 9-month follow-up. Two patients experienced intraoperative carcinoid crisis; one required salvage in-Evoque Sapien S3 deployment. Four patients demonstrated improvement in RV basal diameter. Evoque TTVR is feasible in CHD, but operators must anticipate unique anatomic challenges and carcinoid crisis risk.