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24 May 2017 : Case report  Denmark

Late Obstructive Transcatheter Heart Valve Thrombosis Resolved by Rivaroxaban

Unusual clinical course, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Educational Purpose (only if useful for a systematic review or synthesis)

Ole Norling Mathiassen1BCDEF*, Erik Lerkevang Grove1DE, Nicolaj Christoffer Hansson1DEF, Bjarne Linde Norgaard1CDEF

DOI: 10.12659/AJCR.902798

Am J Case Rep 2017; 18:573-575

Abstract

BACKGROUND: Although transcatheter aortic valve replacement (TAVR) has become a worldwide and generally accepted treatment of patients with aortic stenosis at high surgical risk, there is a rising concern and debate about the occurrence of transcatheter heart valve (THV) thrombosis and its impact on TAVR outcome. It seems that the incidence of THV thrombosis is higher than first anticipated, but uncertainty remains regarding how to prevent and how to treat it. Hence, there is an urgent need for understanding THV thrombosis and to communicate experiences within the field.

CASE REPORT: We present a unique case of late occurrence of THV thrombosis that was resolved by switching from clopidogrel to rivaroxaban treatment.

CONCLUSIONS: As a novel observation, our case demonstrates that THV thrombosis may develop even late after TAVR, and even in such cases may be completely reversed. It also underscores that THV dysfunction should evoke prompt investigation for possible thrombus formation, preferable by multidetector computed tomography. Finally, this case report suggests NOAC as an alternative to warfarin treatment in patients with THV thrombosis.

Keywords: Anticoagulants, Aortic Valve Stenosis, Heart Valve Prosthesis, multidetector computed tomography

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923