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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation

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Valve thrombosis following transcatheter aortic valve implantation: a systematic review

Juan G Córdoba-Soriano1, Rishi Puri1, Ignacio Amat-Santos1

  • 1Quebec Heart & Lung Institute, Quebec City, QC, Canada.

Revista Espanola De Cardiologia (English Ed.)
|February 11, 2015
PubMed

Insights

Valve thrombosis is a rare complication after transcatheter aortic valve implantation. Progressive dyspnea and increased transvalvular gradient suggest thrombosis, which oral anticoagulation effectively treats.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Prosthetic Valve Complications

Background:

  • Transcatheter aortic valve implantation (TAVI) is widely adopted globally.
  • Valve thrombosis following TAVI is not well-characterized.
  • Systematic evaluation of TAVI valve thrombosis is needed.

Purpose of the Study:

  • To determine clinical characteristics of TAVI valve thrombosis.
  • To establish diagnostic criteria for TAVI valve thrombosis.
  • To assess treatment outcomes for TAVI valve thrombosis.

Main Methods:

  • Systematic literature review of studies published 2002-2012.
  • Focused on valve thrombosis as a complication of TAVI.
  • Identified 11 publications describing 16 patients.

Main Results:

  • Most patients received balloon-expandable valves and dual antiplatelet therapy.
  • Valve thrombosis diagnosed median 6 months post-TAVI, presenting as dyspnea.
  • Echocardiography showed increased gradient and leaflet thickening; thrombus not visualized.
  • Warfarin effectively restored valve function in most patients.

Conclusions:

  • Progressive dyspnea and increased transvalvular gradient suggest TAVI valve thrombosis.
  • Direct thrombus visualization is challenging.
  • Prompt oral anticoagulation therapy is effective in restoring valve function.
Abstract

Keywords:
Aortic valve stenosisEstenosis de válvula aórticaImplante percutáneo de válvula aórticaTranscatheter aortic valve implantationTrombosis protésicaValve thrombosis

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