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You are here: Contents > 2016 > Volume 25 Number 2 March 2016 > THROMBOSIS EMBOLISM and BLEEDING > Successful Treatment of Very Early Thrombosis of SAPIEN 3 Valve with Direct Oral Anticoagulant Therapy

Successful Treatment of Very Early Thrombosis of SAPIEN 3 Valve with Direct Oral Anticoagulant Therapy

Neil Ruparelia, Vasileios F. Panoulas, Angela Frame, Nilesh Sutaria, Ben Ariff, Deepa Gopalan, Andrew Chukwuemeka, Ghada W. Mikhail, Iqbal S. Malik

Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK

Thrombosis of transcatheter aortic valve implantation (TAVI) is an uncommon complication that commonly occurs weeks to months following the procedure. Herein are described the details of a patient who presented with a recurrence of symptoms days after intervention with a bioprosthesis thrombosis that was successfully treated with direct oral anticoagulant (DOAC) therapy and resulted in hemodynamic improvement and resolution of symptoms. Whilst a previous trial of DOAC therapy with mechanical valves was stopped due to elevated events in comparison to warfarin, a TAVI valve may be different, and the rapid onset of action and reduced bleeding risk may be beneficial in this patient group.

Video 1: Two-dimensional transesophageal echocardiography (TEE) long-axis view of the aortic valve prosthesis, demonstrating thrombus and reduced valve movement.

Video 2: Two-dimensional transesophageal echocardiography (TEE) long-axis view of the aortic valve prosthesis with color Doppler, demonstrating restricted movement of the valve cusp and resultant turbulent flow.

The Journal of Heart Valve Disease 2016;25:211-213


Successful Treatment of Very Early Thrombosis of SAPIEN 3 Valve with Direct Oral Anticoagulant Therapy

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