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November 13, 2024BMC Cardiovascular DisordersOpen Access

Management of giant left atrial thrombus late after transcatheter mitral valve-in-ring replacement using a transcatheter aortic valve: a case report

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Why the study?

The appropriate anticoagulation regimen following transcatheter mitral valve replacement remains a matter of debate.

Population

One 78-year-old frail female with heart failure, AF, and prior mitral valve annuloplasty undergoing TMVR

Design

Case report

Authors

AMAurel MalokuAHA HamadanchiLBLaura Bäz

Discussion

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Overview

Alerts clinicians to post-TMVR anticoagulation risks in frail AF patients; leaves open optimal regimens for prospective trials.

Structured PICO

P
Population
1 frail 78-year-old female with heart failure, atrial fibrillation, and prior surgical mitral valve repair with left atrial appendage (LAA) excision, who underwent transcatheter mitral valve replacement (TMVR) using a transcatheter aortic valve prosthesis (valve-in-ring).
I
Intervention
Withdrawal of oral anticoagulation
O
Outcome
Development of massive left atrial thrombus and severe stenosis of the mitral valve prosthesissafety

Withdrawal of oral anticoagulation after TMVR in patients with atrial fibrillation and prior LAA excision can lead to massive LA thrombus, suggesting anticoagulation should be maintained despite LAA closure.

Cite This Study

Maloku et al. (2024) studied this question.

synapsesocial.com/papers/6a70f1dcabc331a85807a1a5https://doi.org/10.1186/s12872-024-04260-9
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Early Massive Left Atrial Thrombosis Following Mitral Bioprosthetic Valve Replacement Due to Suboptimal Anticoagulation: A Case Report2025
  2. 2SEVERE MITRAL REGURGITATION TREATED WITH TRANSCATHETER AORTIC VALVE IMPLANTATION IN MITRAL RING (TMVIR): A CASE REPORT2024
  3. 3A case report of transcatheter mitral valve repair in patient with severe acute mitral regurgitation, cardiogenic shock, and left atrial appendage thrombus as a rescue therapy: facing all enemies at once!2021 · 2 citations
  4. 4An under‐recognized high‐risk atrial fibrillation population: Analyzing transcatheter mitral valve repair patients for left atrial appendage closure device application2019 · 6 citations
  5. 5Localized left atrial administration of tPA for the treatment of mechanical mitral valve thrombosis2008 · 8 citations