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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
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Transcatheter Aortic Valve Thrombosis: Incidence, Predisposing Factors, and Clinical Implications

Nicolaj C Hansson1, Erik L Grove2, Henning R Andersen1

  • 1Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.

Journal of the American College of Cardiology
|September 2, 2016
PubMed

Insights

Transcatheter heart valve (THV) thrombosis occurred in 7% of patients post-transcatheter aortic valve replacement (TAVR). Larger THV size increased risk, while warfarin treatment showed a protective effect against THV thrombosis.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Limited data exists on transcatheter heart valve (THV) thrombosis post-transcatheter aortic valve replacement (TAVR).
  • Understanding incidence, clinical impact, and risk factors for THV thrombosis is crucial.

Purpose of the Study:

  • To assess the incidence of THV thrombosis after TAVR.
  • To identify predictors and clinical implications of THV thrombosis.
  • To evaluate the effectiveness of warfarin in managing THV thrombosis.

Main Methods:

  • Contrast-enhanced multidetector computed tomography (MDCT) was used to evaluate 405 patients post-TAVR.
  • MDCT scans were analyzed for hypoattenuated leaflet thickening, indicating THV thrombosis.
  • Follow-up imaging assessed the impact of warfarin treatment.

Main Results:

  • THV thrombosis was detected in 7% of patients (28/405).
  • Larger THV size (29-mm) and absence of warfarin treatment were independent predictors of THV thrombosis.
  • Warfarin treatment was associated with a significantly lower risk of THV thrombosis (1.8% vs. 10.7%).

Conclusions:

  • THV thrombosis occurs in 7% of patients post-TAVR, often subclinically.
  • Larger THV size is a risk factor, while warfarin may be protective.
  • THV thrombosis has significant clinical implications, but warfarin treatment can effectively reverse it.
Abstract

Keywords:
aortic stenosismultidetector computed tomographyplatelet aggregation inhibitorstranscatheter aortic valve replacementwarfarin

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