Key result
Transcatheter mitral valve replacement is associated with a relevant risk of early and late thrombosis, necessitating patient-tailored anticoagulation treatment.
Why the study?
TMVR represents an alternative option for severe mitral regurgitation when repair is unfeasible, but is burdened by device-specific issues including thrombosis.
This review highlights that TMVR carries a higher thrombotic risk than TAVR or surgical mitral valve replacement, underscoring the need for careful, patient-tailored antithrombotic strategies.
May warrant tailored post-TMVR anticoagulation; leaves open optimal regimens for prospective trials.
Mitral regurgitation is the most prevalent form of moderate or severe valve disease in developed countries. Surgery represents the standard of care for symptomatic patients with severe mitral regurgitation, but up to 50% of patients are denied surgery because of high surgical risk. In this context, different transcatheter options have been developed to address this unmet need. Transcatheter mitral valve replacement (TMVR) is an emergent field representing an alternative option in high complex contexts when transcatheter mitral valve repair is not feasible or suboptimal due to anatomical issues. However, TMVR is burdened by some device-specific issues (device malposition, migration or embolization, left ventricular outflow tract obstruction, hemolysis, thrombosis, stroke). Here we discuss the thrombotic risk of TMVR and current evidence about anticoagulation therapy after TMVR.
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Ascione et al. (2021) conducted a review in Mitral regurgitation. Transcatheter Mitral Valve Replacement (TMVR) was evaluated. Transcatheter mitral valve replacement is associated with a relevant risk of early and late thrombosis, necessitating patient-tailored anticoagulation treatment.
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