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Two cases of thrombotic stenosis in SAPIEN XT valves after transapical implantation

EuroIntervention 2014;10:270 published online ahead of print September 2013. DOI: 10.4244/EIJV10I2A44

1. Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark; 2. Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark; 3. Department of Histopathology, Aarhus University Hospital, Aarhu
We report two cases of aortic valve stent thrombosis after uneventful transcatheter transapical aortic valve implantation of the 29 mm Edwards SAPIEN XT (Edwards Lifesciences, Irvine, CA, USA) in high-risk patients. Subcutaneous low molecular weight heparin 5,000 units daily for five days, aspirin 75 mg daily lifelong, and clopidogrel 75 mg daily for 12 months were given. After four weeks, antiplatelet therapy was reduced to monotherapy due to bleeding problems. Shortly after, the patients developed refractory heart failure and died on day 106 and on day 137, respectively. Transoesophageal echocardiography (Online Figure 1 and Moving image 1 and 2) and multislice computed tomography (Figure 1A and Figure 1B) showed signs ...

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