Research status of valvular thrombosis after transcatheter heart valve replacement_West China Medical Journal

Authors：

WANG Yong ,  JIN Jun

Department of Cardiovascular Medicine, the Second Affiliated Hospital of Army Medical University, Chongqing 400037, P. R. China;

Corresponding author：

JIN Jun, Email: jjxqyy@163.com

Keywords：

Transcatheter heart valve; Valve thrombosis; Anticoagulation

DOI：

10.7507/1002-0179.202108094

Video：

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In recent years, the field of transcatheter heart valve interventional therapy has developed rapidly. Valvular thrombosis is a rare postoperative complication, which can affect valvular function early or lead to clinical embolic events, and is gradually being valued by surgeons. The clinical manifestations of thrombosis after different types of interventional valve replacement are different. Although anticoagulant therapy is believed to be effective for valve thrombosis, the selection of anticoagulant drugs and the duration of anticoagulation are still controversial. This article reviews the definition, clinical features, prevention and treatment of valve thrombosis after several types of transcatheter heart valve replacement, mainly related to transcatheter aortic valve replacement and transcatheter mitral valve replacement, and aims to provide a reference for the diagnosis and treatment of valve thrombosis after transcatheter heart valve replacement.

Citation： WANG Yong, JIN Jun. Research status of valvular thrombosis after transcatheter heart valve replacement. West China Medical Journal, 2021, 36(9): 1277-1281. doi: 10.7507/1002-0179.202108094 Copy

1.	Blanke P, Leipsic JA, Popma JJ, et al. Bioprosthetic aortic valve leaflet thickening in the evolut low risk sub-study. J Am Coll Cardiol, 2020, 75(19): 2430-2442.
2.	Mirsadraee S, Sellers S, Duncan A, et al. Bioprosthetic valve thrombosis and degeneration following transcatheter aortic valve implantation (TAVI). Clin Radiol, 2021, 76(1): 73.e39-73.e47.
3.	Ascione G, Denti P. Transcatheter mitral valve replacement and thrombosis: a review. Front Cardiovasc Med, 2021, 8: 621258.
4.	Kappetein AP, Head SJ, Généreux P, et al. Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document (VARC-2). Eur J Cardiothorac Surg, 2012, 42(5): S45-S60.
5.	VARC-3 WRITING COMMITTEE, Généreux P, Piazza N, et al. Valve Academic Research Consortium 3: updated endpoint definitions for aortic valve clinical research. J Am Coll Cardiol, 2021, 77(21): 2717-2746.
6.	Puvimanasinghe JP, Steyerberg EW, Takkenberg JJ, et al. Prognosis after aortic valve replacement with a bioprosthesis: predictions based on meta-analysis and microsimulation. Circulation, 2001, 103(11): 1535-1541.
7.	Mangieri A, Montalto C, Poletti E, et al. Thrombotic versus bleeding risk after transcatheter aortic valve replacement: JACC review topic of the week. J Am Coll Cardiol, 2019, 74(16): 2088-2101.
8.	Chakravarty T, Søndergaard L, Friedman J, et al. Subclinical leaflet thrombosis in surgical and transcatheter bioprosthetic aortic valves: an observational study. Lancet, 2017, 389(10087): 2383-2392.
9.	Makkar RR, Fontana G, Jilaihawi H, et al. Possible subclinical leaflet thrombosis in bioprosthetic aortic valves. N Engl J Med, 2015, 373(21): 2015-2024.
10.	Pache G, Schoechlin S, Blanke P, et al. Early hypo-attenuated leaflet thickening in balloon-expandable transcatheter aortic heart valves. Eur Heart J, 2016, 37(28): 2263-2271.
11.	Ng ACT, Holmes DR, Mack MJ, et al. Leaflet immobility and thrombosis in transcatheter aortic valve replacement. Eur Heart J, 2020, 41(33): 3184-3197.
12.	Oechtering TH, Hons CF, Sieren M, et al. Time-resolved 3-dimensional magnetic resonance phase contrast imaging (4D Flow MRI) analysis of hemodynamics in valve-sparing aortic root repair with an anatomically shaped sinus prosthesis. J Thorac Cardiovasc Surg, 2016, 152(2): 418-427.e1.
13.	Makkar RR, Blanke P, Leipsic J, et al. Subclinical leaflet thrombosis in transcatheter and surgical bioprosthetic valves: PARTNER 3 cardiac computed tomography substudy. J Am Coll Cardiol, 2020, 75(24): 3003-3015.
14.	Yanagisawa R, Tanaka M, Yashima F, et al. Early and late leaflet thrombosis after transcatheter aortic valve replacement. Circ Cardiovasc Interv, 2019, 12(2): e007349.
15.	De Backer O, Dangas GD, Jilaihawi H, et al. Reduced leaflet motion after transcatheter aortic-valve replacement. N Engl J Med, 2020, 382(2): 130-139.
16.	Collet JP, Berti S, Cequier A, et al. Oral anti-Xa anticoagulation after trans-aortic valve implantation for aortic stenosis: The randomized ATLANTIS trial. Am Heart J, 2018, 200: 44-50.
17.	Latib A, Naganuma T, Abdel-Wahab M, et al. Treatment and clinical outcomes of transcatheter heart valve thrombosis. Circ Cardiovasc Interv, 2015, 8(4): e001779.
18.	Ueyama H, Kuno T, Ando T, et al. Meta-analysis comparing direct oral anticoagulants versus vitamin K antagonists after transcatheter aortic valve implantation. Am J Cardiol, 2020, 125(7): 1102-1107.
19.	Ten Berg J, Sibbing D, Rocca B, et al. Management of antithrombotic therapy in patients undergoing transcatheter aortic valve implantation: a consensus document of the ESC Working Group on Thrombosis and the European Association of Percutaneous Cardiovascular Interventions (EAPCI), in collaboration with the ESC Council on Valvular Heart Disease. Eur Heart J, 2021, 42(23): 2265-2269.
20.	Alarfaj M, Jain T, Krepp J. Transcatheter mitral valve thrombosis: a case report and literature review. Catheter Cardiovasc Interv, 2021, 97(6): E887-E892.
21.	Jilaihawi H. Transcatheter heart valve thrombosis on the mitral stage: “the tempest” or “much ado about nothing”?. EuroIntervention, 2021, 16(17): 1386-1387.
22.	Stone GW, Adams DH, Abraham WT, et al. Clinical trial design principles and endpoint definitions for transcatheter mitral valve repair and replacement: part 2: endpoint definitions: a consensus document from the mitral valve academic research consortium. J Am Coll Cardiol, 2015, 66(3): 308-321.
23.	Yoon SH, Whisenant BK, Bleiziffer S, et al. Outcomes of transcatheter mitral valve replacement for degenerated bioprostheses, failed annuloplasty rings, and mitral annular calcification. Eur Heart J, 2019, 40(5): 441-451.
24.	Urena M, Brochet E, Lecomte M, et al. Clinical and haemodynamic outcomes of balloon-expandable transcatheter mitral valve implantation: a 7-year experience. Eur Heart J, 2018, 39(28): 2679-2689.
25.	Kikoïne J, Urena M, Chong Nguyen C, et al. Predictors and clinical impact of thrombosis after transcatheter mitral valve implantation using balloon-expandable bioprostheses. EuroIntervention, 2021, 16(17): 1455-1462.
26.	Kellermair J, Gitter R, Mair R, et al. First report of an acute, obstructive thrombosis of a melody valve used for transcatheter pulmonary replacement. Can J Cardiol, 2018, 34(12): 1688.e13-1688.e15.
27.	Asmarats L, Perlman G, Praz F, et al. Long-term outcomes of the FORMA transcatheter tricuspid valve repair system for the treatment of severe tricuspid regurgitation: insights from the first-in-human experience. JACC Cardiovasc Interv, 2019, 12(15): 1438-1447.
28.	McElhinney DB, Aboulhosn JA, Dvir D, et al. Mid-term valve-related outcomes after transcatheter tricuspid valve-in-valve or valve-in-ring replacement. J Am Coll Cardiol, 2019, 73(2): 148-157.

1. Blanke P, Leipsic JA, Popma JJ, et al. Bioprosthetic aortic valve leaflet thickening in the evolut low risk sub-study. J Am Coll Cardiol, 2020, 75(19): 2430-2442.
2. Mirsadraee S, Sellers S, Duncan A, et al. Bioprosthetic valve thrombosis and degeneration following transcatheter aortic valve implantation (TAVI). Clin Radiol, 2021, 76(1): 73.e39-73.e47.
3. Ascione G, Denti P. Transcatheter mitral valve replacement and thrombosis: a review. Front Cardiovasc Med, 2021, 8: 621258.
4. Kappetein AP, Head SJ, Généreux P, et al. Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document (VARC-2). Eur J Cardiothorac Surg, 2012, 42(5): S45-S60.
5. VARC-3 WRITING COMMITTEE, Généreux P, Piazza N, et al. Valve Academic Research Consortium 3: updated endpoint definitions for aortic valve clinical research. J Am Coll Cardiol, 2021, 77(21): 2717-2746.
6. Puvimanasinghe JP, Steyerberg EW, Takkenberg JJ, et al. Prognosis after aortic valve replacement with a bioprosthesis: predictions based on meta-analysis and microsimulation. Circulation, 2001, 103(11): 1535-1541.
7. Mangieri A, Montalto C, Poletti E, et al. Thrombotic versus bleeding risk after transcatheter aortic valve replacement: JACC review topic of the week. J Am Coll Cardiol, 2019, 74(16): 2088-2101.
8. Chakravarty T, Søndergaard L, Friedman J, et al. Subclinical leaflet thrombosis in surgical and transcatheter bioprosthetic aortic valves: an observational study. Lancet, 2017, 389(10087): 2383-2392.
9. Makkar RR, Fontana G, Jilaihawi H, et al. Possible subclinical leaflet thrombosis in bioprosthetic aortic valves. N Engl J Med, 2015, 373(21): 2015-2024.
10. Pache G, Schoechlin S, Blanke P, et al. Early hypo-attenuated leaflet thickening in balloon-expandable transcatheter aortic heart valves. Eur Heart J, 2016, 37(28): 2263-2271.
11. Ng ACT, Holmes DR, Mack MJ, et al. Leaflet immobility and thrombosis in transcatheter aortic valve replacement. Eur Heart J, 2020, 41(33): 3184-3197.
12. Oechtering TH, Hons CF, Sieren M, et al. Time-resolved 3-dimensional magnetic resonance phase contrast imaging (4D Flow MRI) analysis of hemodynamics in valve-sparing aortic root repair with an anatomically shaped sinus prosthesis. J Thorac Cardiovasc Surg, 2016, 152(2): 418-427.e1.
13. Makkar RR, Blanke P, Leipsic J, et al. Subclinical leaflet thrombosis in transcatheter and surgical bioprosthetic valves: PARTNER 3 cardiac computed tomography substudy. J Am Coll Cardiol, 2020, 75(24): 3003-3015.
14. Yanagisawa R, Tanaka M, Yashima F, et al. Early and late leaflet thrombosis after transcatheter aortic valve replacement. Circ Cardiovasc Interv, 2019, 12(2): e007349.
15. De Backer O, Dangas GD, Jilaihawi H, et al. Reduced leaflet motion after transcatheter aortic-valve replacement. N Engl J Med, 2020, 382(2): 130-139.
16. Collet JP, Berti S, Cequier A, et al. Oral anti-Xa anticoagulation after trans-aortic valve implantation for aortic stenosis: The randomized ATLANTIS trial. Am Heart J, 2018, 200: 44-50.
17. Latib A, Naganuma T, Abdel-Wahab M, et al. Treatment and clinical outcomes of transcatheter heart valve thrombosis. Circ Cardiovasc Interv, 2015, 8(4): e001779.
18. Ueyama H, Kuno T, Ando T, et al. Meta-analysis comparing direct oral anticoagulants versus vitamin K antagonists after transcatheter aortic valve implantation. Am J Cardiol, 2020, 125(7): 1102-1107.
19. Ten Berg J, Sibbing D, Rocca B, et al. Management of antithrombotic therapy in patients undergoing transcatheter aortic valve implantation: a consensus document of the ESC Working Group on Thrombosis and the European Association of Percutaneous Cardiovascular Interventions (EAPCI), in collaboration with the ESC Council on Valvular Heart Disease. Eur Heart J, 2021, 42(23): 2265-2269.
20. Alarfaj M, Jain T, Krepp J. Transcatheter mitral valve thrombosis: a case report and literature review. Catheter Cardiovasc Interv, 2021, 97(6): E887-E892.
21. Jilaihawi H. Transcatheter heart valve thrombosis on the mitral stage: “the tempest” or “much ado about nothing”?. EuroIntervention, 2021, 16(17): 1386-1387.
22. Stone GW, Adams DH, Abraham WT, et al. Clinical trial design principles and endpoint definitions for transcatheter mitral valve repair and replacement: part 2: endpoint definitions: a consensus document from the mitral valve academic research consortium. J Am Coll Cardiol, 2015, 66(3): 308-321.
23. Yoon SH, Whisenant BK, Bleiziffer S, et al. Outcomes of transcatheter mitral valve replacement for degenerated bioprostheses, failed annuloplasty rings, and mitral annular calcification. Eur Heart J, 2019, 40(5): 441-451.
24. Urena M, Brochet E, Lecomte M, et al. Clinical and haemodynamic outcomes of balloon-expandable transcatheter mitral valve implantation: a 7-year experience. Eur Heart J, 2018, 39(28): 2679-2689.
25. Kikoïne J, Urena M, Chong Nguyen C, et al. Predictors and clinical impact of thrombosis after transcatheter mitral valve implantation using balloon-expandable bioprostheses. EuroIntervention, 2021, 16(17): 1455-1462.
26. Kellermair J, Gitter R, Mair R, et al. First report of an acute, obstructive thrombosis of a melody valve used for transcatheter pulmonary replacement. Can J Cardiol, 2018, 34(12): 1688.e13-1688.e15.
27. Asmarats L, Perlman G, Praz F, et al. Long-term outcomes of the FORMA transcatheter tricuspid valve repair system for the treatment of severe tricuspid regurgitation: insights from the first-in-human experience. JACC Cardiovasc Interv, 2019, 12(15): 1438-1447.
28. McElhinney DB, Aboulhosn JA, Dvir D, et al. Mid-term valve-related outcomes after transcatheter tricuspid valve-in-valve or valve-in-ring replacement. J Am Coll Cardiol, 2019, 73(2): 148-157.

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