Thrombotic Risk and Antithrombotic Strategies After Transcatheter Mitral Valve Replacement

Matteo Pagnesi, Francesco Moroni, Alessandro Beneduce, Francesco Giannini, Antonio Colombo, Giora Weisz, Azeem Latib

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)2388-2401
Number of pages14
JournalJACC: Cardiovascular Interventions
Volume12
Issue number23
DOIs
StatePublished - Dec 9 2019
Externally publishedYes

Keywords

  • THV
  • TMVR
  • anticoagulation
  • antithrombotic therapy
  • thrombosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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