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Updated: Aug 5, 2026

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Early Prosthetic Thrombosis After Transcatheter Tricuspid Valve Replacement: A Word of Caution
Francesco Trinca1, Nassim Bousmaha1, Jean Porterie1
1Division of Cardiac Surgery, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada.
Background:
Determinants of early prosthetic thrombosis following transcatheter tricuspid valve replacement (TTVR) are unknown.
Case Summary:
A 70-year-old man with severe tricuspid regurgitation underwent an uneventful TTVR using the EVOQUE system (Edwards Lifesciences). Intravenous heparin was temporarily suspended a few days after the procedure to insert a permanent pacemaker. Sudden clinical deterioration occurred in the following days. Echocardiography demonstrated extensive thrombosis of the TTVR prosthesis, requiring surgical removal. Tricuspid valve repair was not possible because of the anchoring mechanism of the prosthesis, and a tricuspid valve replacement was necessary. The patient's postoperative course was unremarkable.
Discussion:
The optimal management of anticoagulation in patients undergoing TTVR needs to be elucidated.
Take-Home Messages:
Early interruption of anticoagulation after TTVR may be associated with severe prosthetic thrombosis in selected high-risk patients. Surgical TTVR explantation may damage the native tricuspid leaflets and subvalvular apparatus, reducing the likelihood of valve repair.
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