A 76-year-old woman with shortness of breath presented for a follow-up transthoracic echocardiography after transcatheter tricuspid valve replacement (TTVR) with 44 mm Evoque. After the procedure, the patient missed several weeks of her direct oral anticoagulant (DOAC), apixaban. Transthoracic echocardiography (TTE) showed a mean tricuspid valve gradient of 6 mmHg across the tricuspid valve. The patient was therefore sent for a cardiac computed tomography (CCT) to evaluate the tricuspid valve l…