Leaflet immobility and thrombosis in transcatheter aortic valve replacement

被引：35
作者：
Ng, Arnold C. T. [1 ]
Holmes, David R. [2 ]
Mack, Michael J. [3 ]
Delgado, Victoria [4 ]
Makkar, Raj [5 ]
Blanke, Philipp [6 ,7 ]
Leipsic, Jonathon A. [6 ,7 ]
Leon, Martin B. [8 ]
Bax, Jeroen J. [4 ]
机构：
[1] Princess Alexandra Hosp, Dept Cardiol, Brisbane, Qld, Australia
[2] Mayo Clin, Dept Cardiovasc Med, Rochester, MN USA
[3] Baylor Scott & White Hlth, Plano, TX USA
[4] Leiden Univ, Dept Cardiol, Med Ctr, Albinusdreef 2, NL-2333 ZA Leiden, Netherlands
[5] Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA
[6] St Pauls Hosp, Dept Radiol, Vancouver, BC, Canada
[7] Univ British Columbia, Vancouver, BC, Canada
[8] Columbia Univ, New York Presbyterian Hosp, Med Ctr, New York, NY USA
来源：
EUROPEAN HEART JOURNAL | 2020年 / 41卷 / 33期
关键词：
Thrombosis; Transcatheter aortic valve replacement; Antiplatelet therapy; Antithrombotic treatment; Transcatheter heart valve; PROSTHESIS-PATIENT MISMATCH; SINGLE ANTIPLATELET THERAPY; BLOOD STASIS; HEART-VALVE; EUROPEAN ASSOCIATION; CARDIOLOGY ESC; TASK-FORCE; IMPLANTATION; HEMODYNAMICS; PREDICTORS;
D O I：
10.1093/eurheartj/ehaa542
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Transcatheter aortic valve replacement (TAVR) has grown exponentially worldwide in the last decade. Due to the higher bleeding risks associated with oral anticoagulation and in patients undergoing TAVR, antiplatelet therapy is currently considered first-line antithrombotic treatment after TAVR. Recent studies suggest that some patients can develop subclinical transcatheter heart valve (THV) thrombosis after the procedure, whereby thrombus forms on the leaflets that can be a precursor to leaflet dysfunction. Compared with echocardiography, multidetector computed tomography is more sensitive at detecting THV thrombosis. Transcatheter heart valve thrombosis can occur while on dual antiplatelet therapy with aspirin and thienopyridine but significantly less with anticoagulation. This review summarizes the incidence and diagnostic criteria for THV thrombosis and discusses the pathophysiological mechanisms that may lead to thrombus formation, its natural history, potential clinical implications and treatment for these patients. [GRAPHICS] .
引用
收藏
页码：3184 / +
页数：16
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