Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Nov 21;9(11):3742.
doi: 10.3390/jcm9113742.

Predictors and Biomarkers of Subclinical Leaflet Thrombosis after Transcatheter Aortic Valve Implantation

Katarzyna Pieniak  1 , Szymon Jędrzejczyk  1 , Olaf Domaszk  1 , Kajetan Grodecki  1 , Bartosz Rymuza  1 , Zenon Huczek  1 , Janusz Kochman  1 , Krzysztof J Filipiak  1 , Aleksandra Gąsecka  1   2
Affiliations
Review

Predictors and Biomarkers of Subclinical Leaflet Thrombosis after Transcatheter Aortic Valve Implantation

Katarzyna Pieniak et al. J Clin Med. .

Abstract

Transcatheter aortic valve implantation (TAVI) is a recent revolutionary treatment for high-risk patients with severe aortic stenosis who are not suitable for surgery, expanding to intermediate and low-risk patients. Valve leaflet thrombosis (LT) is a potentially fatal complication after TAVI. The incidence of subclinical LT is as high as 25% among patients in the first year after TAVI. Subclinical LT may evolve into symptomatic thrombosis or lead to premature bioprosthesis degeneration, increasing the risk of neurological complications. Because imaging-based methods have limited sensitivity to detect subclinical LT, there is an urgent need for predictors and biomarkers that would make it possible to predict LT after TAVI. Here, we summarize recent data regarding (i) patient-related, (ii) procedure-related, (iii) blood-based and (iv) imaging predictors and biomarkers which might be useful for the early diagnosis of subclinical LT after TAVI. Prevention of LT might offer an opportunity to improve risk stratification and tailor therapy after TAVI.

Keywords: TAVI; aortic stenosis; biomarkers; leaflet thrombosis; predictors.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Procedural characteristics predisposing to leaflet thrombosis (LT) after transcatheter aortic valve implantation.
Figure 2
Figure 2
Platelet-based mechanisms which might potentially underlie leaflet thrombosis after transcatheter aortic valve implantation.
See this image and copyright information in PMC

References

    1. Strange G., Stewart S., Celermajer D., Prior D., Scalia G.M., Marwick T., Ilton M., Joseph M., Codde J., Playford D., et al. Poor long-term survival in patients with moderate aortic stenosis. J. Am. Coll. Cardiol. 2019;74:1851–1863. doi: 10.1016/j.jacc.2019.08.004. - DOI - PubMed
    1. Baumgartner H., Falk V., Bax J.J., De Bonis M., Hamm C., Holm P.J., Iung B., Lancellotti P., Lansac E., Rodriguez Munoz D., et al. 2017 ESC/EACTS guidelines for the management of valvular heart disease. Eur. Heart J. 2017;38:2739–2791. doi: 10.1093/eurheartj/ehx391. - DOI - PubMed
    1. Popma J.J., Deeb G.M., Yakubov S.J., Mumtaz M., Gada H., O’Hair D., Bajwa T., Heiser J.C., Merhi W., Kleiman N.S., et al. Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients. N. Engl. J. Med. 2019;380:1706–1715. doi: 10.1056/NEJMoa1816885. - DOI - PubMed
    1. Mangieri A., Montalto C., Pagnesi M., Lanzillo G., Demir O., Testa L., Colombo A., Latib A. TAVI and post procedural cardiac conduction abnormalities. Front. Cardiovasc. Med. 2018;5:85. doi: 10.3389/fcvm.2018.00085. - DOI - PMC - PubMed
    1. Vavuranakis M., Kariori M., Voudris V., Kalogeras K., Vrachatis D., Aznaouridis C., Moldovan C., Masoura C., Thomopoulou S., Lazaros G., et al. Predictive factors of vascular complications after transcatheter aortic valve implantation in patients treated with a default percutaneous strategy. Cardiovasc. Ther. 2013;31:e46–e54. doi: 10.1111/1755-5922.12023. - DOI - PubMed

LinkOut - more resources