Valve Thrombosis in TTVR Not Uncommon: Meta-analysis
Tausif Salim, Principal Clinical Scientist at Abbott, posted on LinkedIn:
”I’ve been closely and enthusiastically following the topic of valve thrombosis – both clinical and subclinical – following transcatheter tricuspid valve replacement (TTVR). A recent meta-analysis article really highlights some critical considerations that device designers should take into account:
– The tricuspid valve functions under low pressure and is located on the right side of the heart, where blood flow tends to be more stagnant compared to the left side. This reduced blood washout increases the risk of valve thrombosis.
– Some degree of valve thrombosis after TTVR seems inevitable. The key questions are: how significant is the issue, and what are the most effective strategies for managing it?
While thrombosis in the tricuspid position isn’t unexpected, there’s a clear opportunity to reduce its incidence through improved device design from the outset.
Moreover, we must consider the differences in clot formation kinetics and clot material properties between right and left sides of the heart. Hypoxia, which is known to promote thrombosis, adds another point for consideration.
From a scientific standpoint, this is particularly fascinating. Virchow’s triad – developed by Dr. Rudolph Virchow in 1856 to explain venous thrombosis and pulmonary embolism – identified three primary contributors to thrombus formation: venous stasis, endothelial injury, and blood hypercoagulability. The current findings in TTVR thrombosis seem to bring his foundational theory full circle.”
Read the full article here.
Title: Valve Thrombosis in TTVR Not Uncommon: Meta-analysis
Author: Caitlin E. Cox
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