Controversies Regarding Subclinical Leaflet Thrombosis After TAVR

Published: 25 February 2021

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  • episode_image
    10m 22s
    Part 2 | Session 1 PRO Mamas A Mamas
  • episode_image
    10m 45s
    Part 2 | Session 2 CONTRA Poonam Velagapudi
  • episode_image
    11m 47s
    Part 3 | Session 1 PRO Kimberly Atianzar
  • episode_image
    15m 43s
    Part 3 | Session 2 CONTRA Renate B Schnabel
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A substantial number of patients develop a subclinical leaflet thrombosis (SLT) after transcatheter aortic valve replacement (TAVR).

The thrombus forms on the leaflets, which can lead to valve dysfunction and possibly to early valve degeneration. Multidetector computed tomography is the most sensitive imaging technique at detecting SLT.

Patients on antiplatelet drugs are at higher risk to develop SLT as compared to those on anticoagulants. During the live debate, the experts in the field will discuss controversies concerning SLT, including the routine use of oral anticoagulants and CT exams after TAVR.

Learning Objectives

  • To learn about the natural history, incidence and clinical implications of SLT
  • To learn about the mechanisms that may lead to SLT
  • To understand the diagnostic criteria SLT
  • To discuss the prevention and treatment options for SLT


  • Interventional cardiologists with focus on TAVR procedures
  • Cardiac Imaging specialists (Echocardiography, Computer Tomography)
  • General cardiologists
  • Specialists interested in management of antithrombotic therapies after TAVR

More from this programme

Part 1

Subclinical leaflet thrombosis after TAVR: Numbers and facts

Part 2

Debate: Patients should receive routine CT screening after TAVR to exclude subclinical valve thrombosis

Part 3

Debate: Patients should be routinely discharged on oral anticoagulants for prevention of subclinical valve thrombosis after TAVR

Faculty Biographies

Jolanta Siller-Matula

Jolanta Siller-Matula


Dr Jolanta Siller-Matula is an Associate Professor in the Department of Cardiology at the Medical University of Vienna, Austria. She is an interventional cardiologist specialising in coronary and structural cardiac interventions. She is an expert in thrombosis research with a focus on personalized antithrombotic therapies and authored more than 125 peer-reviewed articles (>4500 citations; h-index: 38). Dr Jolanta Siller-Matula is a leader of a clinical research group with a current focus on stratified approaches aiming at optimizing outcomes after PCI and TAVR.

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Mamas A Mamas

Mamas A Mamas

Professor of Cardiology

Professor Mamas Mamas trained in Medicine at the University of Oxford, completing his clinical training in 2000. He is a Professor of Cardiology at Keele University and is a practising interventional cardiologist.

Professor Mamas is an Associate Editor of Circulation Cardiovascular Interventions and a board member of the European Association of Percutaneous Cardiovascular Interventions, European Society of Cardiology. He is the Clinical Director of the Centre for Prognosis Research at Keele University. He leads a group of clinicians, data scientists and statisticians whose research interests focus on using routinely collected electronic healthcare data to inform the diagnosis, treatment and clinical outcomes of real-world patients with cardiovascular disease. He has published over 500 peer-reviewed manuscripts using big data in populations with cardiovascular disease.

Professor Mamas Mamas is an Editorial Board member of…

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Poonam Velagapudi

Poonam Velagapudi

Structural Interventional Cardiologist, Assistant Professor of Medicine and Associate Program Director for Cardiovascular Medicine fellowship at the University of Nebraska

Dr Poonam Velagapudi is a Structural Interventional Cardiologist, Assistant Professor of Medicine and Associate Program Director for Cardiovascular Medicine fellowship at the University of Nebraska. Her clinical interests include high risk PCI, mechanical circulatory support in shock, radial and large bore access, percutaneous transcatheter valve procedures including TAVR, TMVR, and MitraClip. She is a Fellow of the American College of Cardiology (ACC) and the Society for Cardiovascular Angiography and Interventions (SCAI), Chair of the ACC Early Career Section of the, Past Chair of the ACC Fellows in Training Section, and Co-Chair of the SCAI Educational Committee. Her focus is education, advocacy and increasing/promoting participation of women in clinical trials. She is a strong proponent of using social media for fostering education in cardiology and serves as the social media editor for JACC Interventions journal and Early Career Correspondent for ACC ACCEL Audio. She is an…

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Kimberly Atianzar

Kimberly Atianzar


Kimberly Atianzar, MD, is a Director, Structural Heart Program Director, Structural Imaging Assistant Professor of Medicine Medical College of Georgia at Augusta University, Augusta, GA Editor for the Fellows and Early Career Structuralists Forum for Structural Heart: Journal of the Heart Team.

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Renate Schnabel

Renate Schnabel

Consultant in Cardiology

Renate Schnabel is a consultant in cardiology at University Heart Centre Hamburg, Germany. She graduated from medical school in Mainz, Germany in 2002. After a research fellowship at the Framingham Heart Study, Boston University, she moved to Hamburg. She works with clinical and population cohorts and leads national and EU-funded international consortia. She is PI of the German Centre for Cardiovascular Research. Her research interest is in digital cardiology, atrial fibrillation and heart failure, and omics for cardiovascular risk assessment. Very active within professional organizations, she is member on councils of the European Society of Cardiology, American Heart Association and the German Cardiac Society.

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