TRISCEND II: Effect of Transcatheter Tricuspid Valve Replacement on Echocardiographic Measures of Right Heart Remodeling and Function
Recommended Citation
Sannino A, Grayburn PA, Kodali SK, Lurz P, Thourani VH, Makar M, Haeffele C, Puthumana J, Lee J, Flueckiger P, Chadderdon S, Padang R, Sekaran NK, Stewart-Dehner T, Ender J, Koulogiannis K, Morsy M, Miyasaka R, Havens B, Ku I, Silvestry F, Näbauer M, Gleason P, Lindman BR, Ho E, Good M, Gößler T, Cohen JA, Harris A, Sengupta P, Kelly N, Maksoud A, Weber M, Romero S, Yucel E, Raghunathan D, Skolnick D, Wang L, Sun YP, Vainrib A, Kapila A, Mackensen GB, Aman E, Mehrkens D, Ivannikova M, Smith W, Abramson S, Treat S, Toufan M, Mack MJ, Leon MB, Hahn RT. TRISCEND II: Effect of Transcatheter Tricuspid Valve Replacement on Echocardiographic Measures of Right Heart Remodeling and Function. JACC Cardiovasc Imaging. 2026;19(9):1027-1039.
Document Type
Article
Publication Date
9-1-2026
Publication Title
JACC Cardiovasc Imaging
Keywords
Humans, Tricuspid Valve Insufficiency, Ventricular Remodeling, Ventricular Function, Right, Tricuspid Valve, Treatment Outcome, Heart Valve Prosthesis Implantation, Prospective Studies, Cardiac Catheterization, Time Factors, Female, Recovery of Function, Severity of Illness Index, Male, Aged, Predictive Value of Tests, Hemodynamics, Heart Valve Prosthesis, Aged, 80 and over, Prosthesis Design
Abstract
BACKGROUND: The TRISCEND II (EVOQUE Transcatheter Tricuspid Valve Replacement: Pivotal Clinical Investigation of Safety and Clinical Efficacy Using a Novel Device) trial demonstrated clinical benefits for transcatheter tricuspid valve replacement (TTVR) with the EVOQUE System over medical therapy for the primary safety and effectiveness endpoint to 1 year.
OBJECTIVES: The authors report echocardiographic outcomes at 1 year for the randomized cohort and evaluate hemodynamic and structural changes.
METHODS: The multicenter, prospective TRISCEND II trial enrolled 400 patients with severe, symptomatic tricuspid regurgitation (TR) and randomized them in a 2:1 ratio to TTVR (n = 267) or medical therapy (control) (n = 133). The secondary echocardiographic endpoint was reduction in TR severity from baseline to discharge. Echocardiograms were evaluated by an independent echocardiographic core laboratory.
RESULTS: All patients had severe TR at baseline; at discharge, 95.5% of patients who underwent TTVR had mild TR. On paired analysis from baseline to 1 year, 95.3% of patients who underwent TTVR and 2.3% of control patients achieved mild TR. Between baseline and 1 year, the mean inferior vena cava diameter decreased significantly more for patients who underwent TTVR (normal breathing P < 0.001; forced inhalation P = 0.038). Patients who underwent TTVR experienced greater improvements in diastolic right ventricular (RV) size (P < 0.05) and larger decreases in RV systolic function (P < 0.001), consistent with reduced preload from TR reduction. RV stroke volume and cardiac output increased significantly in patients who underwent TTVR (P < 0.001) but not in control patients.
CONCLUSIONS: One-year echocardiographic outcomes from the TRISCEND II trial demonstrated that near elimination of TR following TTVR is associated with reduced venous congestion, RV reverse remodeling, and significant improvements in forward stroke volume and cardiac output. (EVOQUE Transcatheter Tricuspid Valve Replacement: Pivotal Clinical Investigation of Safety and Clinical Efficacy Using a Novel Device [TRISCEND II Pivotal Trial]; NCT04482062).
Medical Subject Headings
Humans; Tricuspid Valve Insufficiency; Ventricular Remodeling; Ventricular Function, Right; Tricuspid Valve; Treatment Outcome; Heart Valve Prosthesis Implantation; Prospective Studies; Cardiac Catheterization; Time Factors; Female; Recovery of Function; Severity of Illness Index; Male; Aged; Predictive Value of Tests; Hemodynamics; Heart Valve Prosthesis; Aged, 80 and over; Prosthesis Design
PubMed ID
42470411
Volume
19
Issue
9
First Page
1027
Last Page
1039
