Controversies Regarding Subclinical Leaflet Thrombosis After TAVR
A substantial number of patients develops 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 anticoagulant. 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.
Mamas A Mamas
Renate B Schnabel
Lecture: Subclinical leaflet thrombosis after TAVR: Numbers and facts Jolanta Siller-Matula
Patients should receive routine CT screening after TAVR to exclude subclinical valve thrombosis
Debate 1: Introduction Jolanta Siller-Matula
Debate 1: PRO Mamas Mamas
Debate 1: CONTRA Poonam Velagapudi
Debate 1: Panel discussion Panel
Patients should be routinely discharged on oral anticoagulants for prevention of subclinical valve thrombosis after TAVR
Introduction Jolanta Siller-Matula
Debate 2: PRO Kimberly Atianzar
Debate 2: CONTRA Renate Schnabel
Debate 2: Panel discussion Panel
- 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
Mamas A Mamas
Mamas Mamas is a Professor of Cardiology at Keele University, UK and Director for the Centre for Prognosis Research. His research group's interest focuses around the use of routinely collected electronic healthcare data to inform the diagnosis, treatment and clinical outcomes of real world patients with cardiovascular disease using national audit data derived from the national cardiovascular societies at the National Institute of Cardiovascular Outcomes Research as well as large datasets from the US. He qualified from Oxford University and has over 300 peer reviewed publications.
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.
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 Associate Editor for the European Heart Journal (EHJ)- Case Reports journal.
Renate B Schnabel
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.
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.