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Pathophysiology, diagnosis and new therapeutic approaches for ischemic mitral regurgitation Transcatheter Interventions for Tricuspid Valve Disease: What to Do and Who to Do it On 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 Novel Transcatheter Mitral Valve Prosthesis for Patients With Severe Mitral Annular Calcification The management of secondary mitral regurgitation in patients with heart failure: a joint position statement from the Heart Failure Association (HFA), European Association of Cardiovascular Imaging (EACVI), European Heart Rhythm Association (EHRA), and European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC Prospective Evaluation of Transseptal TMVR for Failed Surgical Bioprostheses: MITRAL Trial Valve-in-Valve Arm 1-Year Outcomes MITRA-FR vs. COAPT: Lessons from two trials with diametrically opposed results Current Status and Future Prospects of Transcatheter Mitral Valve Replacement: JACC State-of-the-Art Review Functional Mitral Regurgitation Outcome and Grading in Heart Failure With Reduced Ejection Fraction Incidence and Standardized Definitions of Mitral Valve Leaflet Adverse Events After Transcatheter Mitral Valve Repair: the EXPAND Study
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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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