Interventional Tricuspid Valve Replacement: A Structured Sequence of Procedures.

The EVOQUE valve system is the first approved tricuspid valve replacement system developed specifically for the percutaneous implantation of a biological tricuspid valve in patients diagnosed with symptomatic severe tricuspid regurgitation (TR). The implantation procedure is performed through the introduction and advancement of the valve delivery system via the femoral vein. The prosthetic valve consists of a Nitinol frame with a valve made from bovine pericardium. The entire implantation procedure is performed completely percutaneously. Each step of valve positioning, deployment, and implantation is performed while the patient is under general anesthesia. The procedure is carried out under close observation and precise steering using continuous guidance with transesophageal echocardiography (TEE). This protocol presents a comprehensive and detailed step-by-step approach to the interventional endovascular implantation of the EVOQUE tricuspid bioprosthesis under TOE guidance. The procedure has been demonstrated to be both safe and efficient, with most patients achieving complete resolution of tricuspid regurgitation.