Original Research
2020 Sep 1;41(33):3184-3197
JOURNAL：Eur Heart J .
Article Link
Leaflet immobility and thrombosis in transcatheter aortic valve replacement
ACT Ng, DR Holmes, MJ Mack et al.
KEYWORDS
antiplatelet therapy; antithrombotic treatment; thrombosis; transcatheter aortic valve replacement; transcatheter heart valve
Transcatheter aortic valve replacement (TAVR) has grown exponentially
worldwide in the last decade. Due to the higher bleeding risks
associated with oral anticoagulation and in patients undergoing TAVR,
antiplatelet therapy is currently considered first-line antithrombotic
treatment after TAVR. Recent studies suggest that some patients can
develop subclinical transcatheter heart valve (THV) thrombosis after the
procedure, whereby thrombus forms on the leaflets that can be a
precursor to leaflet dysfunction. Compared with echocardiography,
multidetector computed tomography is more sensitive at detecting THV
thrombosis. Transcatheter heart valve thrombosis can occur while on dual
antiplatelet therapy with aspirin and thienopyridine but significantly
less with anticoagulation. This review summarizes the incidence and
diagnostic criteria for THV thrombosis and discusses the
pathophysiological mechanisms that may lead to thrombus formation, its
natural history, potential clinical implications and treatment for these
patients.
http://www.cbsmd.cn Contact us by cbs@cbsmd.cn
Copyright ⓒ CBSMD Nanjing China. All rights reserved.
