71982 | Peri-procedural Imaging and Procedural Characteristics of TTVR With Alternative Access

Document Type

Conference Proceeding

Publication Date

6-1-2025

Publication Title

Struct Heart

Abstract

Background: Transcatheter tricuspid valve replacement (TTVR) with Evoque (Edwards, USA) is a relatively novel therapy in management of patients with severe tricuspid regurgitation (TR) at high risk for surgical intervention. As its commercial availability has expanded its access, patients with broader and more challenging right-sided anatomy are undergoing treatment. Although the device delivery system (DDS) was designed for transfemoral (TF) access, transjugular access has recently shown feasibility in a select group of patients. With expanding usage of alternative access, defined as non-right-femoral vein, familiarity with these patient characteristics is of utmost importance. Methods: Retrospective analysis of all patients who underwent TTVR at a single center between February 2024 and March 2025 was performed. All patients had pre-procedural CCT analyzed for right atrial height, superior vena cava offset, inferior vena cava offset, tricuspid annular angle, and papillary distance. Results: A total of 93 patients were analyzed, of whom 61 had right femoral vein (FV) access, 13 had left FV, 10 had right transjugular (RIJ), and 9 had left transjugular (LIJ) access. Results are demonstrated in Table 1. [Formula presented] Conclusion: Alternative access, with utilization of left FV, RIJ, and LIJ has demonstrated feasibility and safety in TTVR with Evoque. Particularly, in patients with short RA heights alternative access is recommended, and depending on patient characteristics one may select from LFV or transjugular access. Familiarity with these techniques will aid in greater procedural success across a broader spectrum of patient anatomies.

Volume

9

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