Why the study?
Because imaging-based methods have limited sensitivity to detect subclinical leaflet thrombosis after TAVI, predictors and biomarkers are urgently needed to predict its occurrence.
This review highlights the need for and summarizes current evidence on predictors and biomarkers to detect subclinical leaflet thrombosis after TAVI, aiming to improve risk stratification and tailor therapy.
Raises caution for subclinical LT post-TAVI; leaves open optimal antithrombotic strategies in prospective trials.
Transcatheter aortic valve implantation (TAVI) is a recent revolutionary treatment for high-risk patients with severe aortic stenosis who are not suitable for surgery, expanding to intermediate and low-risk patients. Valve leaflet thrombosis (LT) is a potentially fatal complication after TAVI. The incidence of subclinical LT is as high as 25% among patients in the first year after TAVI. Subclinical LT may evolve into symptomatic thrombosis or lead to premature bioprosthesis degeneration, increasing the risk of neurological complications. Because imaging-based methods have limited sensitivity to detect subclinical LT, there is an urgent need for predictors and biomarkers that would make it possible to predict LT after TAVI. Here, we summarize recent data regarding (i) patient-related, (ii) procedure-related, (iii) blood-based and (iv) imaging predictors and biomarkers which might be useful for the early diagnosis of subclinical LT after TAVI. Prevention of LT might offer an opportunity to improve risk stratification and tailor therapy after TAVI.
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Pieniak et al. (2020) studied this question.
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