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Multicenter Study
. 2021 Aug 1;98(2):352-362.
doi: 10.1002/ccd.29555. Epub 2021 Feb 21.

Transcatheter aortic valve thrombosis: Data from a French multicenter cohort analysis

Thomas Mouyen  1 , Thibaut Manigold  2 , Jean-Philippe Collet  3 , Eric Durand  4 , Christophe Barbey  5 , Thibault Lhermusier  6 , Didier Tchetche  7 , Thomas Chollet  7 , Aurélien Mulliez  8 , Pascal Motreff  1 , Nicolas Combaret  1 , Géraud Souteyrand  1
Affiliations
Multicenter Study

Transcatheter aortic valve thrombosis: Data from a French multicenter cohort analysis

Thomas Mouyen et al. Catheter Cardiovasc Interv. .

Abstract

Objectives: To evaluate the effectiveness of anticoagulant therapies in patients with clinical transcatheter heart valve (THV) thrombosis, to describe complications, and to assess their risk profile was the objectives.

Background: Little research has been conducted on clinical THV thrombosis.

Methods: Patients with clinical THV thrombosis were identified based on greater than 50% increased transvalvular gradient on transthoracic echocardiogram confirmed by 4-dimensional computed tomography, transesophageal echocardiogram, or regression with anticoagulant therapy. A cohort free from thrombosis for more than 1,100 days postprocedure was used for comparison.

Results: Fifty-four patients with clinical THV thrombosis were identified. Most subjects (98.1%) received anticoagulant therapy which was effective (≥50% reduction in transvalvular gradient or return to postprocedure value) in 96%. The rate of serious hemodynamic or embolic complications in the thrombosis population was 31.5%. A multivariate analysis of subjects with and without thrombosis indicated a significantly increased risk of thrombosis from preexisting thrombocytopenia (odds ratio [OR] 9.96), absence of predilatation (OR = 5.67), renal insufficiency (OR = 4.84), and >10 mmHg mean transvalvular gradient postprocedure (OR = 3.36). No recurrence of thrombosis was identified during on average 685 days follow-up.

Conclusions: These data, from one of the largest cohorts with clinical THV thrombosis confirm anticoagulants appear effective. The rate of serious associated complications was high. The findings underline the importance of recognizing risk factors for thrombosis.

Keywords: TAVI; aortic stenosis; thrombosis.

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References

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