Early Safety and Feasibility of Internal Jugular Access for EVOQUE Transcatheter Tricuspid Valve Replacement

Authors

• Sureja Sundaralingam, Henry Ford HealthFollow
• Neil Fam
• Gennaro Giustino, Henry Ford HealthFollow
• Mackram Eleid
• Sammy Elmariah
• Jeremiah Depta
• Nicholas Amoroso
• Sidakpal Panaich
• Stephen Krafchak, Henry Ford HealthFollow
• Nathaniel Bowerman, Henry Ford HealthFollow
• Georgi Fram, Henry Ford HealthFollow
• Bryan Zweig, Henry Ford HealthFollow
• John Dawdy, Henry Ford HealthFollow
• James C. Lee, Henry Ford HealthFollow
• Pedro Engel Gonzalez, Henry Ford HealthFollow
• Pedro A. Villablanca, Henry Ford HealthFollow
• Tiberio M. Frisoli, Henry Ford HealthFollow
• Brian P. O'Neill, Henry Ford HealthFollow

Recommended Citation

Sundaralingam S, Fam N, Giustino G, Eleid M, Elmariah S, Depta J, Amoroso N, Panaich S, Krafchak S, Bowerman N, Fram G, Zweig B, Dawdy J, Lee JC, Engel Gonzalez P, Villablanca PA, Frisoli TM, O'Neill BP. Early Safety and Feasibility of Internal Jugular Access for EVOQUE Transcatheter Tricuspid Valve Replacement. JACC Cardiovasc Interv 2026; 19(5):S77-S78.

Document Type

Conference Proceeding

Publication Date

3-9-2026

Publication Title

JACC Cardiovasc Interv

Keywords

Cardiovascular System & Cardiology

Abstract

BACKGROUND: The EVOQUE transcatheter tricuspid valve replacement system (TTVR) is FDA-approved for transfemoral access. However, there may be some patients in whom a femoral approach is not feasible. We sought to evaluate the feasibility and safety of the EVOQUE TTVR System implanted via (internal jugular) IJ approach. METHODS: This was a retrospective multi-center study conducted amongst Evoque centers in the United States and Canada between June 2021 to September 2025. We included patients who had previously failed implant with the EVOQUE or who were felt to be challenging from a transfemoral perspective. The feasibility endpoint was defined as successful delivery of the valve in its intended position and removal of the delivery system. Additional endpoints included residual tricuspid regurgitation (TR) reduction, NYHA, Kansas City quality of life questionnaire (KCCQ) improvements at 30 days. The safety endpoints included mortality, new pacemaker implantation, and need for emergency surgery. RESULTS: A total of 33 patients underwent IJ EVOQUE implantation. The mean age was 77.5 ± 5.4 years. The majority, 78.8% were women and 86.2% were white. The mean baseline left ventricular ejection fraction was 57.5%. A total of 66.7% of patients had pre-existing atrial fibrillation and 33.3% had cardiac implantable electronic devices. The mean KCCQ score improved from baseline 45.1 ± 24.63 to 62.5 ± 19.8 at 30 days. NYHA III/IV improved from baseline (72.7%) to NYHA III (10.3%) at 30 days. There were no deaths, 2 patients required surgical intervention, and 2 required permanent pacemakers. Fig. 1 shows TR reduction rates. CONCLUSION: EVOQUE implantation via the IJ approach was feasible with acceptable safety in patients with a previous failed transfemoral attempt or challenging anatomy and resulted in excellent TR reduction. Dedicated systems are needed to help facilitate IJ delivery.

Volume

19

Issue

5

First Page

S77

Last Page

S78