Transcatheter Aortic Heart Valve Thrombosis: Incidence, Predisposing Factors, and Clinical Implications

In this retrospective review of 460 consecutive patients undergoing transcatheter aortic valve implantation with the Edwards Sapiens XT or Sapiens 3 prosthesis, the authors analyse the incidence, clinical implications and predisposing factors related to trancatheter heart valve (THV) thrombosis. Of the 460 patients, 405 (88%) underwent multidetector computed tomography in addition to TTE and transesophageal echocardiography (TEE). The incidence of THV thrombosis was 7% (28 of 405 patients). Of these, 5 patients (18%) developed heart failure symptoms during the 12-month follow-up period. The use of a 29 mm THV and no warfarin post-TAVR treatment were independently associated with an increased risk of THV thrombosis. Treatment with warfarin effectively reversed THV thrombosis findings and normalized THV function.