Department of Aerospace Engineering, Auburn University, Auburn, AL, USA.
Abbott Laboratories, Abbott Park, IL, USA.
J R Soc Interface. 2021 Nov;18(184):20210599. doi: 10.1098/rsif.2021.0599. Epub 2021 Nov 24.
Transcatheter aortic valve (TAV) thrombosis has been recognized as a significant problem that sometimes occurs as early as within 30 days after valve implantation, leading to increased concerns of stroke and long-term valve durability. In this article, a critical summary of the relevant literature on identifying potential mechanisms of TAV thrombosis from the perspective of the well-known Virchow's triad, which comprises blood flow, foreign materials and blood biochemistry, is presented. Blood flow mechanisms have been the primary focus thus far, with a general consensus on the flow mechanisms with respect to haemodynamic conditions, the influence of TAV placement and expansion and the influence of coronary flow. Less attention has been paid to the influence of blood biochemistry and foreign materials (and related endothelial damage), with little consensus among studies with regards to platelet and/or microparticle levels post-TAV implantation. Finally, we discuss the future outlook for research with unanswered scientific questions.
经导管主动脉瓣（TAV）血栓已被认为是一个严重的问题，有时在瓣膜植入后 30 天内就会发生，这导致人们对中风和长期瓣膜耐久性的担忧增加。在本文中，从著名的Virchow 三联征（包括血流、异物和血液生物化学）的角度，对 TAV 血栓形成的潜在机制的相关文献进行了批判性总结。迄今为止，血流机制一直是主要关注点，对于血流机制与血流动力学条件、TAV 放置和扩张的影响以及冠状动脉血流的影响已经达成了普遍共识。对血液生物化学和异物（以及相关的内皮损伤）的影响关注较少，并且在 TAV 植入后的血小板和/或微颗粒水平方面，研究之间几乎没有共识。最后，我们讨论了未来研究的前景和未解决的科学问题。
