Late transcatheter aortic valve thrombotic obstruction

A 70-year-old caucasian male was admitted for elective aortic valve replacement (AVR) because of severe, symp tom atic aortic stenosis. Preoperative transthoracic echocardiography (TTE) showed a concentric hypertrophic left ventricle with preserved left ventricular ejection fraction (EF 65%) and a severely calcified aortic valve with a maximum pressure gradient (PG) of 82 mm Hg and a mean PG of 52 mm Hg. The preoperative left and right heart catheterisation revealed a mean PG of 54 mm Hg and an aortic valve area (AVA, according to the Gorlin Equation) of 0.74 cm 2 . Preprocedural coronary angio graphy revealed only minor coronary artery disease. The EuroSCORE II was 2.15% and the STS score for mortality was 1.11%. Owing to a Figure 1: Transoesophageal echocardiography views of the prosthetic aortic valve before starting anticoagulation (short axis [A] and long axis [B]). A B Summary Late valve thrombosis is uncommon after trans catheter aortic valve implantation. Herein, we describe such a complication after transcatheter aortic valve implantation of an Edwards SAPIEN XT aortic bioprosthesis valve.