Echocardiographic Imaging Considerations for Post-Implant Evaluation of the Transcatheter EVOQUE Tricuspid Valve Replacement System

The transcatheter EVOQUE tricuspid valve replacement system is an approved device for the treatment of patients with symptomatic severe tricuspid regurgitation despite medical therapy both in the United States and in Europe. Specific imaging requirements are needed in the screening and in the intraprocedural phase as well as to assess this valve after implantation, in order to assess its positioning and performance. In this review, focus will be on the postoperative echocardiographic assessment of device positioning and stability; evaluation of residual central tricuspid regurgitation or paravalvular leak; valve thrombosis/degeneration; interaction of the device frame with the right ventricle and adjacent structures, including the aortic valve and interventricular septum; and placement of pacemaker leads. This review will therefore be centered on these essential imaging aspects in the echocardiographic postimplantation evaluation of the EVOQUE valve.