Thromb Haemost 2019; 19(10): 1590-1605
DOI: 10.1055/s-0039-1694751
Theme Issue Article
Georg Thieme Verlag KG Stuttgart · New York

Thrombogenicity and Antithrombotic Strategies in Structural Heart Interventions and Nonaortic Cardiac Device Therapy—Current Evidence and Practice

Tobias Geisler
1  Department of Cardiology and Angiology, University Hospital, Eberhard-Karls University of Tübingen, Tübingen, Germany
,
Rezo Jorbenadze
1  Department of Cardiology and Angiology, University Hospital, Eberhard-Karls University of Tübingen, Tübingen, Germany
,
Aron-Frederik Popov
2  Department of Thoracic and Cardiovascular Surgery, University Medical Center Tübingen, Eberhard-Karls University of Tübingen, Tübingen, Germany
,
Karin L. Mueller
1  Department of Cardiology and Angiology, University Hospital, Eberhard-Karls University of Tübingen, Tübingen, Germany
,
Dominik Rath
1  Department of Cardiology and Angiology, University Hospital, Eberhard-Karls University of Tübingen, Tübingen, Germany
,
1  Department of Cardiology and Angiology, University Hospital, Eberhard-Karls University of Tübingen, Tübingen, Germany
,
Juergen Schreieck
1  Department of Cardiology and Angiology, University Hospital, Eberhard-Karls University of Tübingen, Tübingen, Germany
,
Peter Seizer
1  Department of Cardiology and Angiology, University Hospital, Eberhard-Karls University of Tübingen, Tübingen, Germany
,
Robert F. Storey
3  Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
,
Steen D. Kristensen
4  Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
,
Andrea Rubboli
5  Division of Cardiology, Department of Cardiovascular Disease–AUSL Romagna, Ospedale S. Maria delle Croci, Ravenna, Italy
,
Diana Gorog
6  National Heart and Lung Institute, Imperial College London, London, United Kingdom
7  University of Hertfordshire, Hertfordshire, United Kingdom
,
Daniel Aradi
8  Heart Center Balatonfured, Balatonfured, Hungary
9  Heart and Vascular Center, Semmelweis University, Budapest, Hungary
,
Dirk Sibbing
10  Department of Cardiology, LMU München, Munich, Germany
11  DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
,
Kurt Huber
12  3rd Department of Medicine, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria
13  Medical Faculty, Sigmund Freud University, Vienna, Austria
,
Meinrad Gawaz
1  Department of Cardiology and Angiology, University Hospital, Eberhard-Karls University of Tübingen, Tübingen, Germany
,
Jur Ten Berg
14  Department of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands
› Author Affiliations
Funding This project was funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) Klinische Forschungsgruppe-KFO-274 “Platelets - Molecular Mechanisms and Translational Implications” (Project number 190538538) and TRR 240 “Platelets - Molecular, cellular and systemic functions in health and disease” (Project number 374031971).
Further Information

Publication History

12 April 2019

21 June 2019

Publication Date:
17 August 2019 (eFirst)

Abstract

As the number of, and the indications for, structural heart interventions are increasing worldwide, the optimal secondary prevention to reduce device thrombosis is becoming more important. To date, most of the recommendations are empiric. The current review discusses mechanisms behind device-related thrombosis, the available evidence with regard to antithrombotic regimen after cardiac device implantation, as well as providing an algorithm for identification of risk factors for device thrombogenicity and for management of device thrombosis after implantation of patent foramen ovale and left atrial appendage occluders, MitraClips/transcatheter mitral valve replacement, pacemaker leads, and left ventricular assist devices. Of note, the topic of antithrombotic therapy and thrombogenicity of prostheses in aortic position (transcatheter aortic valve replacement, surgical, mechanical, and bioprostheses) is not part of the present article and is discussed in detail in other contemporary focused articles.