Transcatheter Tricuspid Valve Replacement With EVOQUE and Mitral Valve Repair With PASCAL in One Procedure

Mitral and tricuspid regurgitation, linked to high morbidity and mortality, are increasingly treated with interventional edge-to-edge repair, showing excellent results in favorable anatomy. Recently, interventional valve replacement strategies have emerged. We present a patient with severe dyspnea and leg edema who was diagnosed with severe mitral and torrential tricuspid regurgitation. In one procedure, she underwent mitral edge-to-edge repair with a PASCAL Ace and transcatheter tricuspid valve replacement with an EVOQUE 48 mm (both Edwards Lifesciences). Tricuspid regurgitation was reduced to trace, and mitral regurgitation was mild and stable at 1 month of follow-up. It is still being determined whether mitral and tricuspid regurgitation should be treated simultaneously or in stages. Recent data show favorable results for simultaneous treatment, but tricuspid regurgitation may improve after mitral valve repair alone. Mitral and tricuspid regurgitation can be effectively treated in challenging anatomies with new replacement devices in a single procedure, offering patients fast and safe relief from both conditions.