Transcatheter Heart Valve Thrombosis: Incidence, Predictors, And Clinical Outcomes

Abstract

Since its initial approval, the number of transcatheter aortic valve replacement procedures performed has increased exponentially with evolving indications that now include patients at intermediate risk for perioperative mortality following surgery. Multiple studies and reports have observed the phenomenon of leaflet dysfunction and thrombosis on follow-up imaging that may be associated with serious adverse outcomes. This review provides an insight into the incidence, predictors, management, and follow-up of transcatheter heartvalve thrombosis.

Transcatheter Heart Valve Thrombosis in a Patient With Polycythemia Vera Despite Apixaban Therapy for Atrial Fibrillation

“…THV thrombosis can be defined as: 1) THV dysfunction secondary to thrombosis, diagnosed based on regression of new-onset heart failure symptoms after initiation of anticoagulation therapy, along with a reduction in the mean gradient on echocardiography; or 2) a mobile mass detected on a THV suspicious for thrombus, irrespective of dysfunction, and in the absence of infection, or by definitive imaging or histopathologic findings ( 2 ). The most common findings by echocardiography are an increasing transvalvular gradient, thickened THV leaflets with or without impaired mobility, and visualization of thrombus formation on the valve ( 2 ). Transesophageal echocardiogram, although invasive, provides direct visualization of the THV leaflets and can assess leaflet motion and identify abnormal leaflet thickening.…”