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Apixaban Curbs Subclinical Thrombosis After TAVI in Patients Without Prior OAC


May 17, 2021
Use of apixaban (Eliquis; Bristol-Myers Squibb) following transcatheter aortic valve implantation does not significantly reduce the risk of subclinical valve thrombosis when compared with standard of care, according to a CT substudy from the ATLANTIS trial presented today.
However, the results are nuanced, with investigators reporting an intriguing interaction between thrombus risk and prior oral anticoagulation indication. For patients without an indication for oral anticoagulation, use of apixaban as opposed to antiplatelet therapy was associated with a lower risk of subclinical valve thrombosis as measured by reduced leaflet motion (RLM) and hypoattenuated leaflet thickening (HALT).
By contrast, for those with an indication for oral anticoagulation, apixaban failed to prevent subclinical valve thrombosis when compared with a vitamin K antagonist. ....

France General , Gilles Montalescot , Andrew Goldsweig , Adnan Chhatriwalla , Baylor Scott White , Joao Cavalcante , Bristol Myers Squibb , Michael Mack , David Cohen , American College Of Cardiology , Phd Centre Hospitalier Universitaire Piti , Md University Of Nebraska Medical Center , Heart Center , Md Saint Luke Mid America Heart Institute , Md Minneapolis Heart Institute , American College , Centre Hospitalier Universitaire Piti , Francis Hospital , Evolut Low Risk Trial , Nebraska Medical Center , Baylor Scott , White Heart Hospital , Minneapolis Heart Institute , Saint Luke , Mid America Heart Institute , Kansas City ,

Surgery After Failed Mitral Edge-to-Edge Repair Tends to Be Replacement


May 05, 2021
When surgery is needed to correct residual or recurrent mitral regurgitation (MR) after transcatheter edge-to-edge repair (TEER), chances are that the patient will need to have the valve replaced rather than repaired, shows a study using the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database.
Of patients who had mitral surgery after TEER nearly all of which would have been done with the MitraClip (Abbott) during the study period only 4.8% underwent surgical repair rather than replacement, Joanna Chikwe, MD (Cedars-Sinai Medical Center, Los Angeles, CA), reported during the virtual American Association for Thoracic Surgery 2021 meeting over the weekend. ....

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