Thrombolytic Therapy as the Management of Mitral Transcatheter Valve-in-Valve Implantation Early Thrombosis

Akhras, Nathem; Sergani, Hani Al; Buraiki, Jehad Al; Fadel, Bahaa M.; Khaliel, Feras; Allaf, Abdalkareem Al; Amri, Mohammed Al; Dahdouh, Ziad

doi:10.1016/j.hlc.2015.12.003

Cited by 10 publications

(9 citation statements)

References 10 publications

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“…Thirteen patients developed access‐site bleeding after TMVIV implantation. Other vascular complications occurred in two patients including one case of thrombosis on the ventricular aspect of the mitral valve prosthesis and one case of left ventricular (LV) apical pseudoaneurysm. Most patients (98.2%) were categorized as NYHA grade II or lower postprocedure.…”

Section: Resultsmentioning

confidence: 99%

“…From 2009 to March 31, 2018, 66 published reports describing 172 patients undergoing TMVIV implantation for degenerated mitral bioprostheses and 35 articles describing 73 patients undergoing TMVIR implantation for failed annuloplasty rings were identified (Figure ). The patients were diagnosed with MR, MS, or mixed lesions according to the articles but the failure modes of 34 patients were unknown.…”

Section: Resultsmentioning

confidence: 99%

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Transcatheter mitral valve implantation for degenerated mitral bioprostheses or failed surgical annuloplasty rings: A systematic review and meta-analysis

Chen

Cheng

et al. 2018

J Card Surg

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BackgroundTranscatheter mitral valve‐in‐valve (TMVIV) and valve‐in‐ring (TMVIR) implantation for degenerated mitral bioprostheses and failed annuloplasty rings have recently emerged as treatment options for patients deemed unsuitable for repeat surgery.MethodsA systematic literature review was conducted to summarize the data regarding the baseline characteristics and clinical outcomes of patients undergoing TMVIV and TMVIR procedures.ResultsA total of 245 patients (172 patients who underwent TMVIV surgery and 73 patients who underwent TMVIR surgery) were included in the study; 93.5% of patients experienced successful TMVIV or TMVIR implantation. The mortality rates at discharge, 30 days, and 6 months were 5.7%, 8.1%, and 23.4%, respectively. The transapical (TA) access route was used in most procedures (55.2%). The TA and transseptal (TS) access routes resulted in similar outcomes. No significant differences were observed in the short‐term outcomes between the patients who developed mitral stenosis versus mitral regurgitation as the mode of failure.ConclusionsTMVIV and TMVIR implantation for degenerated mitral bioprostheses and failed annuloplasty rings are safe and effective. Both procedures, via TA or TS access, can result in excellent short‐term clinical outcomes in patients with mitral stenosis or regurgitation, but long‐term follow‐up data are currently lacking to determine the durability of these procedures.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Transcatheter mitral valve implantation for degenerated mitral bioprostheses or failed surgical annuloplasty rings: A systematic review and meta-analysis

Chen

Cheng

et al. 2018

J Card Surg

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“…A recent clinical study has suggested that the frequency of post-TAVR thrombus formation may be as high as 40% [6]. In addition, valve thrombosis has been increasingly observed in patients undergoing valve-in-valve (ViV) procedures [7][8][9][10]. The thrombotic materials after TAVR and ViV procedures are predominantly found on the aortic side of the leaflets (Figs 1a, 1b) [6,7,11].…”

mentioning

confidence: 99%

Blood Stasis on Transcatheter Valve Leaflets and Implications for Valve-in-Valve Leaflet Thrombosis

Vahidkhah

Javani

Abbasi

et al. 2017

The Annals of Thoracic Surgery

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Geometric confinement of the TAV by the leaflets and the frame of the degenerated bioprosthesis that circumferentially surround the TAV stent increases the BRT on the leaflets, which may act as a permissive factor in the TAV leaflet thrombosis after ViV procedure. A similar distribution pattern of BRT observed on the TAV leaflets may explain the similar rate of occurrence of thrombosis on the three leaflets.

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“…Marti et al reported thrombotic material on all three leaflets of a SAPIEN XT implanted within a CoreValve THV. Furthermore, thrombus formation has also been observed on a SAPIEN XT in a Hancock II bioprosthesis following transcatheter mitral ViV implantation …”

Section: Leaflet Thrombosis In Transcatheter Valve‐in‐valvementioning

confidence: 92%

“…Furthermore, thrombus formation has also been observed on a SAPIEN XT in a Hancock II bioprosthesis following transcatheter mitral ViV implantation. 52 Geometric confinement of THV by the failed bioprosthesis increases the blood residence time (BRT) on the THV leaflets. 53 This may act as a permissive factor in valve or leaflet thrombosis following TAVR or ViV procedures.…”

Section: Bicuspid Versus Trileaflet Thrombosis In Tavrmentioning

confidence: 99%

Subclinical leaflet thrombosis following transcatheter aortic valve replacement

Kanjanauthai

Pirelli

Nalluri

et al. 2018

J Interven Cardiology

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Since the inception of transcatheter aortic valve replacement (TAVR), there have been significant reductions in complications due to improvements of transcatheter heart valve (THV) designs and technologies. Given expanding TAVR applications, reducing complications further and better understanding THV durability has become a focus within the structural heart space. Recently, dedicated cardiac computed tomographic angiography (CTA) performed at 1 month post-TAVR has identified subclinical leaflet thrombosis (SLT), with rates as high as 40%. From the SLT imaging hallmarks of hypoattenuated leaflet thickening (HALT) to hypoattenuation affecting motion (HAM), a postulated timeline of THV thrombosis advancing to clinical symptoms can be recognized. This review article focuses on leaflet thrombosis particularly following TAVR explaining the spectrum of this disease process, its diagnosis, current treatment options, and future directions in the field.

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Thrombolytic Therapy as the Management of Mitral Transcatheter Valve-in-Valve Implantation Early Thrombosis

Cited by 10 publications

References 10 publications

Transcatheter mitral valve implantation for degenerated mitral bioprostheses or failed surgical annuloplasty rings: A systematic review and meta-analysis

Transcatheter mitral valve implantation for degenerated mitral bioprostheses or failed surgical annuloplasty rings: A systematic review and meta-analysis

Blood Stasis on Transcatheter Valve Leaflets and Implications for Valve-in-Valve Leaflet Thrombosis

Subclinical leaflet thrombosis following transcatheter aortic valve replacement

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