ABSTRACT
Severe mitral regurgitation (MR) is fairly common in the general
population and is associated with significant morbidity and mortality.
Although surgical mitral valve (MV) repair and replacement are well
established treatment options for MV disease, as much as one-half of
patients with severe, symptomatic MR are not referred for surgery due to
prohibitive procedural risk. Novel transcatheter alternatives are
therefore being developed to provide an alternative treatment for these
patients. A growing experience with transcatheter MV replacement (TMVR)
strategies is accumulating and promising early results have been
reported. However, the risk of transcatheter heart valve (THV)
thrombosis seems to be relevant after TMVR, potentially higher than that
observed after transcatheter aortic valve replacement, and routine
anticoagulant therapy appears to be necessary to mitigate this risk.
Hereafter, the authors: 1) review available evidence on thrombotic risk
after TMVR (including new dedicated THVs for native MV, valve-in-valve,
valve-in-ring, and valve-in-mitral annular calcification); and 2)
discuss the antithrombotic treatment strategies after TMVR.