Late Transcatheter Aortic Valve Thrombosis Leading to Cardiogenic Shock

Abstract

A 67-year-old woman with prior transcatheter aortic valve replacement presented with worsening dyspnea. Imaging revealed transcatheter aortic valve thrombosis and aortic stenosis. Despite oral anticoagulation, she progressively deteriorated and developed cardiogenic shock. We highlight the Heart Team's role in treating this unusual late thrombosis. (Level of Difficulty: Intermediate.).

Keywords: CT, computed tomography; DAPT, dual antiplatelet therapy; HALT, hypoattenuated leaflet thrombosis; IABP, intra-aortic balloon pump; LVEF, left ventricular ejection fraction; OAC, oral anticoagulation; SAPT, single antiplatelet therapy; SAVR, surgical aortic valve replacement; TAV, transcatheter aortic valve; TAVR, transcatheter aortic valve replacement; TEE, transesophageal echocardiography; TTE, transthoracic echocardiography; hypoattenuated leaflet thrombosis; transcatheter heart valve.