Prosthetic valve dysfunction post-bevacizumab: a transcatheter aortic valve replacement thrombosis case report

Area of Science:

• Cardiology
• Ophthalmology
• Pharmacology

Background:

• Transcatheter aortic valve replacement (TAVR) thrombosis is a recognized complication.
• The association between TAVR thrombosis and vascular endothelial growth factor (VEGF) inhibitors remains unexplored.

Observation:

• A 69-year-old male with a history of TAVR experienced prosthetic valve dysfunction after receiving bevacizumab for age-related macular degeneration.
• Echocardiography indicated moderate aortic stenosis with significantly increased gradients post-bevacizumab administration.

Findings:

• A temporal association was observed between bevacizumab administration and TAVR valve dysfunction.
• Discontinuation of bevacizumab and initiation of anticoagulation led to normalization of valve function at three months.

Implications:

• This case highlights a potential risk of TAVR thrombosis with VEGF inhibitors like bevacizumab in patients with bioprosthetic valves.
• Clinicians should consider this association and maintain vigilant echocardiographic monitoring in relevant patients.
• Further research is necessary to establish a causal link between VEGF inhibitors and TAVR thrombosis.