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Early Portuguese Experience with the EVOQUE Tricuspid Valve: Procedural and Early Outcomes
Session:
Sessão de Comunicações Orais 01 – Dentro do Laboratório de Hemodinâmica: estratégias contemporâneas e resultados na vida real
Speaker:
Ana L. Silva
Congress:
CPC 2026
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.3 Non-coronary Cardiac Intervention
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Ana L. Silva; Tatiana Pereira dos Santos; Gonçalo Ferraz Costa; Ana Botelho; José Luís Martins; Manuel Santos; Luís Paiva; Marco Costa; Lino Gonçalves
Abstract
<p style="text-align:justify"><strong>Introduction: </strong>Transcatheter tricuspid valve replacement (TTVR) has emerged as a promising option for severe symptomatic tricuspid regurgitation (TR), but real-world data outside pivotal trials are still limited.<br /> <strong>Purpose:</strong> To evaluate procedural and 30-day outcomes of the EVOQUE system implantation in a real-world Portuguese cohort.<br /> <strong>Methods: </strong>Retrospective, single-center study including consecutive patients undergoing TTVR with the EVOQUE valve (Edwards Lifesciences), between October 2024 and October 2025. Baseline characteristics, procedural metrics, and early clinical outcomes were collected.<br /> <strong>Results: </strong>Eighteen patients were included (median age 79.5 [IQR 10.0] years; 44.4% male). TR was severe in 27.8%, massive in 16.7%, and torrential in 55.6%. TR etiology was mixed primary/functional in 44.4%, followed by atrial/ventricular functional TR in 38.9%. Degenerative disease (5 cases), valve prolapse (2), and electrocatheter impingement (2) were the most frequent primary causes. Mean TRISCORE was 3.3±1.9, and 94.4% were in NYHA II–III. Median NT-proBNP was 1801.5 pg/mL (IQR 3084.8). Atrial fibrillation was present in 94.5%, and 16.7% had a previous pacemaker.<br /> Baseline right ventricle (RV) function included mean fractional area change (FAC) 39.8±7.0%, TAPSE 17.8±4.1mm, RV strain −19.3±3.5%, and TAPSE/sPAP 0.44±0.12. Right heart catheterization was performed in 94.4%, revealing pulmonary hypertension in 12 patients (27.8% precapillary, 22.2% postcapillary, 16.7% combined). Mean pulmonary artery pressure was 23.6±6.3mmHg and PCWP 15.6±5.7mmHg.<br /> Median procedural duration was 112.5 minutes (IQR 33.8). The 52-mm valve was the most used (38.9%). TR reduction was achieved in all patients: none/trace in 33.3%, mild in 55.6%, and moderate in 11.1%. Mean transprosthetic gradient was 3.2±1.1mmHg. Post-operative worsening of RV function was observed: RV strain −12.4±3.7% (p<0.001), TAPSE 10.9±3.9mm (p<0.001), and FAC 25.4±7.6% (p<0.001). Procedural complications included one cardiac tamponade and one acute heart failure requiring inotropes. No in-hospital mortality occurred. Median hospitalization was 4.5 days (IQR 2.3).<br /> At 30 days, two patients required pacemaker implantation for complete heart block (2/15 patients, 13.3%), two were rehospitalized for heart failure (11.1%), one had a transient ischemic attack, and one was hospitalized for access-site hematoma.<br /> <strong>Conclusions:</strong> Our center experience aligns with TRISCEND-II, supporting the safety and efficacy of EVOQUE TTVR in real-world practice. Notably, the pacemaker implantation rate was substantially lower than the 24.7% reported in TRISCEND-II. These findings reinforce the expanding role of TTVR as a viable therapeutic option for severe symptomatic TR.</p>
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