TY - JOUR
T1 - Thrombotic Risk and Antithrombotic Strategies After Transcatheter Mitral Valve Replacement
AU - Pagnesi, Matteo
AU - Moroni, Francesco
AU - Beneduce, Alessandro
AU - Giannini, Francesco
AU - Colombo, Antonio
AU - Weisz, Giora
AU - Latib, Azeem
N1 - Funding Information:
Dr. Latib has served on the advisory board for Medtronic, Abbott Vascular, and Cardiovalve. Dr. Weisz has served on the medical advisory board for Corindus, Eco Fusion, Filterlex, Medivizor, and Trisol; and has received institutional research grants from Abbott Vascular, Corindus, Cardiovascular Systems, Inc., CSL Behring, RenalGuard, and Svelte. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Publisher Copyright:
© 2019 American College of Cardiology Foundation
PY - 2019/12/9
Y1 - 2019/12/9
N2 - 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.
AB - 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.
KW - THV
KW - TMVR
KW - anticoagulation
KW - antithrombotic therapy
KW - thrombosis
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U2 - 10.1016/j.jcin.2019.07.055
DO - 10.1016/j.jcin.2019.07.055
M3 - Review article
C2 - 31806220
AN - SCOPUS:85075274727
SN - 1936-8798
VL - 12
SP - 2388
EP - 2401
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
IS - 23
ER -