Highlights the association between delayed bioprosthetic valve thrombosis, ventricular remodeling, and subtherapeutic anticoagulation post-TAVI, demonstrating successful management with warfarin intensification.
May support warfarin intensification for post-TAVI thrombosis; hypothesis-generating and should not yet change practice.
A 78-year-old female developed symptomatic bioprosthetic valve thrombosis 32 months post-transapical TAVI, despite 6-month warfarin therapy. Echocardiography showed severe hemodynamic compromise with left ventricular remodeling and diastolic dysfunction. CT-confirmed thrombosis resolved after warfarin intensification and cardiac optimization, achieving mean gradient reduction to 17 mmHg within 8 weeks. This highlights the association between delayed thrombosis, ventricular remodeling, and subtherapeutic anticoagulation.
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Yuan et al. (2026) studied this question.
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