Transcatheter tricuspid valve replacement-a comparison of clinical and procedural outcomes of two different prostheses.

BACKGROUND: Transcatheter Tricuspid Valve Replacement (TTVR) has emerged as a treatment option for patients with severe tricuspid regurgitation (TR) who are at high surgical risk and unsuitable for tricuspid transcatheter edge-to-edge repair (T-TEER). OBJECTIVES: This study aims to compare procedural, clinical and echocardiographic outcomes of two different TTVR devices: the Cardiovalve (Venus MedTech) and the EVOQUE (Edwards Lifesciences) prosthesis. METHODS: We performed a retrospective, single-center cohort analysis including all consecutive patients who were treated with TTVR. Primary endpoints included TR reduction, NYHA class and safety events according to TVARC criteria. RESULTS: Overall, 25 consecutive patients were included in the analysis. The Cardiovalve prosthesis was implanted in 12 patients and the EVOQUE prosthesis in 13 patients. Intraprocedural success was 100%. There was a significant reduction in TR grade (4.20 vs. 0.48; p < 0.001) and NYHA class (2.72 vs. 1.88; p = 0.004) for the overall cohort at 30-day follow-up, but no differences between the two devices (TR grade 0.50 vs. 0.46; p = 0.408 and NYHA class 1.75 vs. 2.00; p = 0.813; Cardiovalve and EVOQUE respectively). Mortality rate at 30 days was 0% in both groups. One patient in each group (8.0%) required new pacemaker implantation. CONCLUSION: TTVR with both, the Cardiovalve and EVOQUE prothesis is an effective treatment option, leading to profound TR reduction and meaningful clinical improvement at 30-day follow-up. Patient selection and long term follow up need to be the focus of future studies.