Transjugular Approach for Evoque Transcatheter Tricuspid Valve Replacement in Patients With Challenging Anatomy.

Authors

Jonathan X. Fang, Henry Ford HealthFollow
Pedro A. Villablanca, Henry Ford HealthFollow
Tiberio M. Frisoli, Henry Ford HealthFollow
Gennaro GiustinoFollow
Leo Kar Lok Lai, Henry Ford HealthFollow
James C. Lee, Henry Ford HealthFollow
Pedro Engel Gonzalez, Henry Ford HealthFollow
Bryan Zweig, Henry Ford HealthFollow
Hussayn Alrayes, Henry Ford HealthFollow
Georgi K. Fram, Henry Ford HealthFollow
Felix Nguyen, Henry Ford HealthFollow
Ahmad Jabri
Tyler Andrews, Henry Ford HealthFollow
Omar Abdelhai, Henry Ford HealthFollow
Gautam Rangavajla, Henry Ford HealthFollow
William W. O'Neill, Henry Ford HealthFollow
Brian P. O’Neill, Henry Ford HealthFollow

Recommended Citation

Fang JX, Villablanca PA, Frisoli TM, Giustino G, Lai LKL, Lee JC, Engel Gonzalez P, Zweig B, Alrayes H, Fram GK, Nguyen F, Jabri A, Andrews T, Abdelhai O, Rangavajla G, O'Neill WW, and O'Neill BP. Transjugular Approach for Evoque Transcatheter Tricuspid Valve Replacement in Patients With Challenging Anatomy. Circ Cardiovasc Interv 2025;e015276.

Document Type

Article

Publication Date

8-19-2025

Publication Title

Circ Cardiovasc Interv

Abstract

BACKGROUND: The Evoque system is the first commercially available transcatheter tricuspid valve replacement (TTVR) system in the United States. However, challenging anatomy in real-world patients could preclude successful transfemoral Evoque TTVR. We aim to investigate the feasibility of the transjugular Evoque TTVR in anatomy unsuitable for a transfemoral approach.

METHODS: Eleven patients with challenging anatomy underwent transjugular Evoque TTVR at a high-volume center in the United States from February 2024 to January 2025, following an unsuccessful transfemoral attempt (n=9) or anatomic unsuitability (n=2). Procedural characteristics, intraprocedural success, periprocedural outcomes, echocardiographic findings, and 30-day clinical outcomes were assessed using the Tricuspid Valve Academic Research Consortium definitions. The procedural technique is provided in the accompanying supplement.

RESULTS: Intraprocedural success was achieved in all 11 patients, with reasonable procedural time and no major procedural complications, except for 1 pacemaker implantation. At 30 days, the clinical success rate was 100%. Tricuspid regurgitation was reduced to none-to-trivial in 8 patients, mild in 2 patients, and moderate in 1 patient. There was no stroke, mortality, or rehospitalization. Nine out of 11 patients experienced an improvement in New York Heart Association functional class.

CONCLUSIONS: In the largest single-center cohort of patients reported to date, transjugular Evoque TTVR demonstrated favorable intraprocedural, periprocedural, and short-term clinical outcomes, and was found to be a feasible alternative for patients with anatomy unsuitable for transfemoral Evoque TTVR.

PubMed ID

40827406

ePublication

ePub ahead of print

First Page

015276

Last Page

015276