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Percutaneous Repair or Medical Treatment for Secondary Mitral Regurgitation: Outcomes at 2 years Association Between Malignant Mitral Valve Prolapse and Sudden Cardiac Death: A Review Patient and Hospital Characteristics of Mitral Valve Surgery in the United States Thrombotic Risk and Antithrombotic Strategies After Transcatheter Mitral Valve Replacement Initial experience with percutaneous mitral valve repair in patients with cardiac amyloidosis Transcatheter Interventions for Mitral Regurgitation: Multimodality Imaging for Patient Selection and Procedural Guidance The Tricuspid Annular Plane Systolic Excursion to Systolic Pulmonary Artery Pressure Index: Association With All-Cause Mortality in Patients With Moderate or Severe Tricuspid Regurgitation Closure of Iatrogenic Atrial Septal Defect Following Transcatheter Mitral Valve Repair: The Randomized MITHRAS Trial Italian Society of Interventional Cardiology (GIse) Registry Of Transcatheter Treatment of Mitral Valve RegurgitaTiOn (GIOTTO): Impact of Valve Disease Etiology and Residual Mitral Regurgitation after MitraClip Implantation Outcomes of TTVI in Patients With Pacemaker or Defibrillator Leads: Data From the TriValve Registry
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Review ArticleJACC: Cardiovascular Interventions

JOURNAL：JACC Cardiovasc Interv. Article Link

Thrombotic Risk and Antithrombotic Strategies After Transcatheter Mitral Valve Replacement

M Pagnesi, F Moroni, A Beneduce et al. Keywords: antithrombotic therapy; anticoagulation; thrombosis; THV; TMVR

ABSTRACT

Severe mitral regurgitation (MR) is fairly common in the general population and is associated with significant morbidity and mortality. Although surgical mitral valve (MV) repair and replacement are well established treatment options for MV disease, as much as one-half of patients with severe, symptomatic MR are not referred for surgery due to prohibitive procedural risk. Novel transcatheter alternatives are therefore being developed to provide an alternative treatment for these patients. A growing experience with transcatheter MV replacement (TMVR) strategies is accumulating and promising early results have been reported. However, the risk of transcatheter heart valve (THV) thrombosis seems to be relevant after TMVR, potentially higher than that observed after transcatheter aortic valve replacement, and routine anticoagulant therapy appears to be necessary to mitigate this risk. Hereafter, the authors: 1) review available evidence on thrombotic risk after TMVR (including new dedicated THVs for native MV, valve-in-valve, valve-in-ring, and valve-in-mitral annular calcification); and 2) discuss the antithrombotic treatment strategies after TMVR.
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