Subclinical Leaflet Thrombosis After Transcatheter Aortic Valve Replacement

An imaging substudy of GALILEO suggests that oral anticoagulation can reduce the frequency of these findings, but the harm overall outweighs the benefit.

According to recent studies, aortic leaflet thickening, reduced leaflet motion, or both occur frequently in patients undergoing transcatheter aortic valve replacement (TAVR) and suggest a potential association with thromboembolic events. Although observational studies have suggested that oral anticoagulants can prevent these findings, no clinical trials have tested this approach, and the risk–benefit ratio is unknown. To learn more, researchers prospectively enrolled 231 post-TAVR patients into an imaging substudy (NCT02833948) of the industry-sponsored, open-label GALILEO clinical trial (NEJM JW Cardiol Nov 16 2019; [e-pub] and N Engl J Med 2019 Nov 16; [e-pub]), which compared a rivaroxaban-based regimen with standard dual antiplatelet th…

Reviewing Author

David J. Cohen, MD, MSc

Disclosures

Consultant/Advisory BoardMedtronic; Edwards Lifesciences; Abbott Vascular; Boston Scientific; St. Francis Hospital

Speaker’s BureauBoston Scientific; ZOLL Medical

Grant/Research SupportEdwards Lifesciences; Abbott Vascular; Boston Scientific; Corvia Medical; National Heart, Lung, and Blood Institute; Phillips, Inc.; St. Paul’s Hospital; V-Wave, Inc; ZOLL Medical; CathWorks, ANCORA

Editorial BoardsJACC; American Heart Journal; EuroIntervention; JSCAI; Structural Heart Journal

Leadership Positions in Professional SocietiesSociety of Thoracic Surgeons/American College of Cardiology TVT Registry (Co-Chair, Risk Model Development Committee); Cardiovascular Research Foundation (Co-Director, TCT Annual Meeting; Co-Director, New York Valves Annual Meeting)

David J. Cohen, MD, MSc

Disclosures

Consultant/Advisory BoardMedtronic; Edwards Lifesciences; Abbott Vascular; Boston Scientific; St. Francis Hospital

Speaker’s BureauBoston Scientific; ZOLL Medical

Editorial BoardsJACC; American Heart Journal; EuroIntervention; JSCAI; Structural Heart Journal

Subclinical Leaflet Thrombosis After Transcatheter Aortic Valve Replacement

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Reviewing Author