Percutaneous Paravalvular Leak Closure of the EVOQUE Transcatheter Tricuspid Valve Replacement System
A 57-year-old man with severe tricuspid regurgitation, surgical mechanical aortic valve replacement, and atrial fibrillation underwent successful transcatheter tricuspid valve replacement (TTVR) with the 56 mm EVOQUE system. Transthoracic echocardiogram post-TTVR demonstrated trivial paravalvular leak (PVL) and a transvalvular gradient of 3.6 mmHg (Online Video 1). He presented 1 year later with worsening fatigue, dyspnea on exertion, and peripheral edemas. Repeat transesophageal echocardiography and cardiac computed tomography demonstrated the presence of two new paravalvular leaks (PVLs), one septal-anterior at 2 o’clock of at least moderate severity (Figure 1a-c) and one postero-lateral moderate-to-severe at 8 o’clock (Figure 1d-f), with unchanged transvalvular gradients.
