Conclusion:
The incidence of THV thrombosis after TMVR remains largely unknown. Until unless systemic echocardiographic follow-up is not performed, this complication may remain undiagnosed.
Mild raised trans mitral gradients on trans thoracic gradients usually overlook the post TMVR thrombus that’s why systemic TEE may be necessary during follow-up of these patients and must be mandatory in patients with elevated trans mitral gradients.
Early or late subclinical prosthetic valve thrombosis may occur frequently after TMVR, and long-term anticoagulant therapy may therefore be necessary in combination with antiplatelet therapy despite the increased bleeding risk.