What is the clinical evidence from this study?

Study design: Review. Population: Prosthetic Heart Valve Thrombosis. Intervention: Prosthetic heart valves.

What question did this study set out to answer?

This review aims to examine the incidence of prosthetic heart valve thrombosis and the mechanisms behind thrombus formation.

April 23, 2026

Prosthetic Heart Valve Thrombosis

Key Result

This review outlines the pathophysiological mechanisms of prosthetic valve thrombosis and its clinical implications for patients undergoing transcatheter and surgical valve replacement.

Key Points

This review aims to examine the incidence of prosthetic heart valve thrombosis and the mechanisms behind thrombus formation.
Review the current literature on prosthetic valve thrombosis.
Discuss pathophysiological mechanisms contributing to valve thrombus development.
Analyze the implications for patients undergoing transcatheter valve replacement.
Thromboembolism risk persists in patients with bioprosthetic heart valves beyond the initial postoperative months.
Mechanical heart valves require long-term anticoagulation to prevent thrombosis, unlike bioprosthetic valves, which have uncertain needs.
BHV thrombosis may indicate a reversible cause of prosthesis dysfunction.

Structured PICO

Population

Patients with prosthetic heart valves (mechanical or bioprosthetic, surgical or transcatheter)

This review summarizes data on prosthetic valve thrombosis, its pathophysiological mechanisms, and implications in the era of transcatheter valve replacement.

Abstract

Although surgery was the mainstay of treatment for valvular heart disease, transcatheter valve therapies have grown exponentially over the past decade. Two types of artificial heart valve exist: mechanical heart valves (MHV), which are implanted surgically, and bioprosthetic heart valves (BHV), which can be implanted via a surgical or transcatheter approach. Whereas long-term anticoagulation is required to prevent thromboembolism after MHV replacement, its value in patients receiving BHVs is uncertain. Patients undergoing transcatheter BHV replacement are at risk for thromboembolism in the first few months, and recent data suggest that the risk continues thereafter. BHV thrombosis provides a substrate for subsequent thromboembolism and may identify a reversible cause of prosthesis dysfunction. Hereafter, the authors: 1) review the data on prosthetic valve thrombosis; 2) discuss the pathophysiological mechanisms that may lead to valve thrombus formation; and 3) provide perspective on the implications of these findings in the era of transcatheter valve replacement.