Rescue transcatheter tricuspid valve replacement with a 56-mm expandable prosthesis following edge-to-edge repair: a case report

Tricuspid regurgitation (TR) is a challenging condition, particularly in advanced stages. Transcatheter therapies are emerging as viable alternatives for selected patients.

We present an 85-year-old woman with longstanding right heart failure symptoms and torrential TR who underwent edge-to-edge repair (T-TEER), complicated by single leaflet partial device attachment (SLDA). Her condition deteriorated, with readmission for decompensated heart failure. Given persistent torrential TR, clinical deterioration, and unsuitable anatomy for further leaflet-based repair due to septal leaflet plastering, she underwent successful transcatheter tricuspid valve replacement (TTVR) with a newly available 56-mm prosthesis. The patient experienced symptomatic and haemodynamic improvement.

This case highlights the limitations of leaflet-based repair in anatomically complex TR and supports TTVR as an effective alternative even in SLDA cases. The availability of newer, larger valve sizes expands its feasibility, reinforcing its role in patients previously considered unsuitable for intervention.