A case report of acute prothesis thrombosis after emergent transcatheter aortic valve replacement_West China Medical Journal

Authors：

LIU Qi , CHEN Fei , LI Yijian , XU Yuanning , LI Xi , ZHAO Zhengang , XIONG Tianyuan , WANG Zijie , OU Yuanweixiang , WANG Xi ,  CHEN Mao ,  FENG Yuan

Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

CHEN Mao, Email: hmaochen@vip.sina.com; FENG Yuan, Email: fynotebook@hotmail.com

Keywords：

Transcatheter aortic valve replacement; Prothesis thrombosis; Anticoagulation

DOI：

10.7507/1002-0179.202003058

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

This article reports a patient diagnosed with severe aortic stenosis. After admission, the cardiac multidisciplinary team performed transcatheter aortic valve replacement (TAVR) emergently due to its unstable hemodynamics. The procedure was successful, and the initial cardiogram during the operation after TAVR suggested that the stenosis was greatly improved. But gradually the next day bedside echocardiography suggested that the transvalvular pressure difference increased and the prosthetic valve forward blood flow accelerated. Acute valve thrombosis after TAVR was taken into consideration. Warfarin and heparin were administrated for anticoagulation, after which the pressure difference across the valve and the forward blood flow rate of the artificial valve were evenly improved.

Citation： LIU Qi, CHEN Fei, LI Yijian, XU Yuanning, LI Xi, ZHAO Zhengang, XIONG Tianyuan, WANG Zijie, OU Yuanweixiang, WANG Xi, CHEN Mao, FENG Yuan. A case report of acute prothesis thrombosis after emergent transcatheter aortic valve replacement. West China Medical Journal, 2020, 35(4): 418-424. doi: 10.7507/1002-0179.202003058 Copy

1.	Del Trigo M, Muñoz-Garcia AJ, Wijeysundera HC, et al. Incidence, timing, and predictors of valve hemodynamic deterioration after transcatheter aortic valve replacement. J Am Coll Cardiol, 2016, 67(6): 644-655.
2.	Pache G, Schoechlin S, Blanke P, et al. Early hypo-attenuated leaflet thickening in balloon-expandable transcatheter aortic heart valves. Eur Heart J, 2015, 37(28): 2263-2271.
3.	Vollema EM, Kong WKF, Katsanos S, et al. Transcatheter aortic valvethrombosis: the relation between hypo-attenuated leaflet thickening, abnormal valve haemodynamics, and stroke. Eur Heart J, 2017, 38(16): 1207-1217.
4.	D’Ascenzo F, Salizzoni S, Saglietto A, et al. Incidence, predictors and cerebrovascular consequences of leaflet thrombosis after transcatheter aortic valve implantation: a systematic review and meta-analysis. Eur J Cardiothorac Surg, 2019, 56(3): 488-494.
5.	De Marchena E, Mesa J, Pomenti S, et al. Thrombus formation following transcatheter aortic valve replacement. JACC Cardiovasc Interv, 2015, 8(5): 728-739.
6.	Chakravarty T, Abramowitz Y, Jilaihawi H, et al. Leaflet motion abnormality after TAVI: genuine threat or much ado about nothing?. EuroIntervention, 2016, 12(Y): Y28-Y32.
7.	Hansson NC, Grove EL, Andersen HR, et al. Transcatheter aortic valve thrombosis: incidence, predisposing factors, and clinical implications. J Am Coll Cardiol, 2016, 68(19): 2059-2069.
8.	Kounis NG, Lianas D, Kounis GN, et al. Very early, early, and late thrombus formation following transcatheter aortic valve replacement: a kounis syndrome involvement?. JACC Cardiovasc Interv, 2016, 9(8): 861.
9.	Trantalis G, Toutouzas K, Latsios G, et al. TAVR and thrombosis. JACC Cardiovasc Imaging, 2017, 10(1): 86-87.
10.	Jilaihawi H, Asch FM, Manasse E, et al. Systematic CT methodology for the evaluation of subclinical leaflet thrombosis. JACC Cardiovasc Imaging, 2017, 10(4): 461-470.
11.	Patanè F, Sansone F, Campanella A, et al. Acute bioprosthetic thrombosis immediately after aortic valve replacement. J Cardiovasc Med (Hagerstown), 2009, 10(2): 167-169.
12.	Ruile P, Neumann FJ. Valve thrombosis after TAVI. Eur Heart J, 2017, 38(36): 2700-2701.
13.	Mylotte D, Andalib A, Thériault-Lauzier P, et al. Transcatheter heart valve failure: a systematic review. Eur Heart J, 2015, 36(21): 1306-1327.
14.	Geisler T, Droppa M, Muller K, et al. Antithrombotic therapy after TAVR. Curr Vasc Pharmacol, 2018, 16(5): 437-445.
15.	Camaj A, Claessen BE, Mehran R, et al. The importance of the Heart Team evaluation before transcatheter aortic valve replacement: results from the BRAVO-3 trial. Catheter Cardiovasc Interv, 2020.
16.	Sondergaard L, Sigitas C, Chopra M, et al. Leaflet thrombosis after TAVI. Eur Heart J, 2017, 38(36): 2702-2703.
17.	Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol, 2017, 70(2): 252-289.
18.	Kalogeras K, Jabbour RJ, Ruparelia N, et al. Comparison of warfarin versus DOACs in patients with concomitant indication for oral anticoagulation undergoing TAVI; results from the ATLAS registry. J Thromb Thrombolysis, 2019.
19.	Dangas GD, Tijssen JGP, Wöhrle J, et al. A controlled trial of rivaroxaban after transcatheter aortic-valve replacement. N Engl J Med, 2020, 382(2): 120-129.

1. Del Trigo M, Muñoz-Garcia AJ, Wijeysundera HC, et al. Incidence, timing, and predictors of valve hemodynamic deterioration after transcatheter aortic valve replacement. J Am Coll Cardiol, 2016, 67(6): 644-655.
2. Pache G, Schoechlin S, Blanke P, et al. Early hypo-attenuated leaflet thickening in balloon-expandable transcatheter aortic heart valves. Eur Heart J, 2015, 37(28): 2263-2271.
3. Vollema EM, Kong WKF, Katsanos S, et al. Transcatheter aortic valvethrombosis: the relation between hypo-attenuated leaflet thickening, abnormal valve haemodynamics, and stroke. Eur Heart J, 2017, 38(16): 1207-1217.
4. D’Ascenzo F, Salizzoni S, Saglietto A, et al. Incidence, predictors and cerebrovascular consequences of leaflet thrombosis after transcatheter aortic valve implantation: a systematic review and meta-analysis. Eur J Cardiothorac Surg, 2019, 56(3): 488-494.
5. De Marchena E, Mesa J, Pomenti S, et al. Thrombus formation following transcatheter aortic valve replacement. JACC Cardiovasc Interv, 2015, 8(5): 728-739.
6. Chakravarty T, Abramowitz Y, Jilaihawi H, et al. Leaflet motion abnormality after TAVI: genuine threat or much ado about nothing?. EuroIntervention, 2016, 12(Y): Y28-Y32.
7. Hansson NC, Grove EL, Andersen HR, et al. Transcatheter aortic valve thrombosis: incidence, predisposing factors, and clinical implications. J Am Coll Cardiol, 2016, 68(19): 2059-2069.
8. Kounis NG, Lianas D, Kounis GN, et al. Very early, early, and late thrombus formation following transcatheter aortic valve replacement: a kounis syndrome involvement?. JACC Cardiovasc Interv, 2016, 9(8): 861.
9. Trantalis G, Toutouzas K, Latsios G, et al. TAVR and thrombosis. JACC Cardiovasc Imaging, 2017, 10(1): 86-87.
10. Jilaihawi H, Asch FM, Manasse E, et al. Systematic CT methodology for the evaluation of subclinical leaflet thrombosis. JACC Cardiovasc Imaging, 2017, 10(4): 461-470.
11. Patanè F, Sansone F, Campanella A, et al. Acute bioprosthetic thrombosis immediately after aortic valve replacement. J Cardiovasc Med (Hagerstown), 2009, 10(2): 167-169.
12. Ruile P, Neumann FJ. Valve thrombosis after TAVI. Eur Heart J, 2017, 38(36): 2700-2701.
13. Mylotte D, Andalib A, Thériault-Lauzier P, et al. Transcatheter heart valve failure: a systematic review. Eur Heart J, 2015, 36(21): 1306-1327.
14. Geisler T, Droppa M, Muller K, et al. Antithrombotic therapy after TAVR. Curr Vasc Pharmacol, 2018, 16(5): 437-445.
15. Camaj A, Claessen BE, Mehran R, et al. The importance of the Heart Team evaluation before transcatheter aortic valve replacement: results from the BRAVO-3 trial. Catheter Cardiovasc Interv, 2020.
16. Sondergaard L, Sigitas C, Chopra M, et al. Leaflet thrombosis after TAVI. Eur Heart J, 2017, 38(36): 2702-2703.
17. Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol, 2017, 70(2): 252-289.
18. Kalogeras K, Jabbour RJ, Ruparelia N, et al. Comparison of warfarin versus DOACs in patients with concomitant indication for oral anticoagulation undergoing TAVI; results from the ATLAS registry. J Thromb Thrombolysis, 2019.
19. Dangas GD, Tijssen JGP, Wöhrle J, et al. A controlled trial of rivaroxaban after transcatheter aortic-valve replacement. N Engl J Med, 2020, 382(2): 120-129.

West China Medical Journal

A case report of acute prothesis thrombosis after emergent transcatheter aortic valve replacement

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content