Prosthetic Heart Valve Thrombosis

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• 作者：George D. Dangas ; MD ; PhD^a ; ^{george.dangas@mountsinai.org} ; ^{gdangas@crf.org} ; Jeffrey I. Weitz ; MD^b ; Gennaro Giustino ; MD^a ; Raj Makkar ; MD^c ; Roxana Mehran ; MD^a
• 关键词：antithrombotic therapies ; valve replacement ; valvular heart disease
• 刊名：Journal of the American College of Cardiology
• 出版年：2016
• 出版时间：20 December 2016
• 年：2016
• 卷：68
• 期：24
• 页码：2670-2689
• 全文大小：1562 K
• 卷排序：68

文摘

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.