TCT-167 Transjugular Transcatheter Tricuspid Valve Replacement With the Evoque System

Document Type

Conference Proceeding

Publication Date

10-29-2024

Publication Title

J Am Coll Cardiol

Abstract

Background: The transcatheter tricuspid valve replacement (TTVR) Evoque system is designed to be delivered to the right ventricle via right or left transfemoral (TF) access. However, certain patients may not be a candidate for TF access. We report our experience of TTVR with Evoque via right internal jugular (RIJ) access in patients who were not suitable for TF-TTVR. Methods: From February 2024, a total of 36 patients were screened for TF-TTVR with the Evoque valve at a tertiary center (Henry Ford Health System, Detroit, Michigan). Among these, 29 underwent successful TTVR and in 7 cases the procedure was aborted. Among the aborted cases, 4 were reevaluated and underwent attempted TTVR via RIJ. In 4/5 patients referred for RIJ-TTVR after failed TF-TTVR, the reason for aborting TF-TTVR was the inability to achieve sufficient right atrial height leading to excessive RV implant depth. Results: Clinical and procedural characteristics of the 5 patients who underwent RIJ-TTVR are reported in Table 1. All cases were performed with the patient under general anesthesia and with TEE guidance. There were no periprocedural adverse events, and all cases were technically successful. [Formula presented] Conclusions: In the largest case series of nontransfemoral TTVR with Evoque reported to date, the RIJ appeared to be a feasible, safe, and effective alternative vascular access that overcomes some of the anatomic constraints encountered from the transfemoral route. Further insights into pre-procedural anatomic analysis are necessary to identify patients who may benefit from an upfront RIJ-TTVR approach. Categories: STRUCTURAL: Valvular Disease: Tricuspid.

Volume

84

Issue

18

First Page

B418

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