TRISCEND II: Transcatheter Replacement vs. Medical Treatment for Tricuspid Regurgitation

The EVOQUE device is designed with an intra-annular sealing system that provides excellent anatomical compatibility and an adaptable shape. It is currently available in four sizes (44 mm, 48 mm, 52 mm, and 56 mm) and is implanted using a 28-Fr transfemoral access.

TRISCEND II: Reemplazo transcatéter vs tratamiento médico en insuficiencia tricúspidea 

The TRISCEND II study aimed to assess the efficacy and safety of the EVOQUE system compared to optimal medical therapy (OMT). It included patients with severe tricuspid regurgitation (TR) who experienced heart failure symptoms and were already under OMT at the time of inclusion. Patients with a life expectancy of less than 12 months, ejection fraction <25%, severe right ventricular dysfunction, or severe pulmonary hypertension were excluded from the trial.

A total of 400 patients were randomized 2:1 to either transcatheter tricuspid valve replacement (TTVR) with the EVOQUE device or OMT alone. The average participant age was 79.3 years, and 74.9% of subjects were women. Most patients (73%) experienced dyspnea classified as NYHA functional class III or IV, while 96% had atrial fibrillation, and 36% had an implantable pacemaker or cardioverter-defibrillator (ICD).

Successful implantation of the EVOQUE device was achieved in 95.4% of patients, with an average hospital stay of three days. Cardiovascular mortality was higher in the OMT group (7.8% vs. 5.7%). Clinical benefit was measured using the win probability ratio, which was 2.02 in favor of TTVR, thus indicating that patients treated with the EVOQUE device had nearly double the likelihood of clinical improvement compared to the control group.

Read also: COMPARE TAVI: One-Year Results of a Randomized Study Comapring Two Balloon-Expandable Valves.

From a hemodynamic perspective, TTVR with the EVOQUE system significantly reduced TR to mild or less in almost all patients. This reduction led to a significant improvement in symptoms, better functionality, and improved quality of life after one year of follow-up.

Presented by Raj Makkar at Top Late-Breaking Trials, PCR London Valves, November 24, 2024, London, Great Britain.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

Dr. Omar Tupayachi
Dr. Omar Tupayachi
Member of the Editorial Board of solaci.org

More articles by this author

Percutaneous Treatment of Atrial Functional Mitral Regurgitation

Atrial functional mitral regurgitation (aFMR), which results from atrial dilation without significant left ventricular dysfunction, accounts for approximately one-third of mitral regurgitation (MR) cases...

ACURATE Neo2 Underexpansion: Prevalence and Clinical Implications

While transcatheter aortic valve replacement (TAVR) provides durable clinical benefits across a wide range of patients, technical challenges remain that may affect long-term outcomes....

Measuring Post-TAVI Gradients and Their Implications: Are Invasive and Echocardiographic Assessments Comparable?

Transcatheter aortic valve implantation (TAVI) is considered the treatment of choice for a significant proportion of patients with symptomatic aortic stenosis. Outcomes have improved...

Percutaneous Tricuspid Valve Replacement with Lux-Valve

Tricuspid regurgitation (TR) is a condition associated with poor quality of life, frequent hospitalizations due to heart failure, and increased mortality, even under optimal...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Percutaneous Treatment of Atrial Functional Mitral Regurgitation

Atrial functional mitral regurgitation (aFMR), which results from atrial dilation without significant left ventricular dysfunction, accounts for approximately one-third of mitral regurgitation (MR) cases...

ACURATE Neo2 Underexpansion: Prevalence and Clinical Implications

While transcatheter aortic valve replacement (TAVR) provides durable clinical benefits across a wide range of patients, technical challenges remain that may affect long-term outcomes....

Spontaneous Left Main Dissection: Clinical Characteristics, management and Outcomes

Courtesy of Dr. Juan Manuel Pérez. Spontaneous left main dissection in an uncommon, and potentially life-threatening, cause of acute MI. The aim of this study,...