Severe mitral regurgitation (MR) is fairly common in the general population and is associated with significant morbidity and mortality. Although surgical mitral valve (MV) repair and replacement are well established treatment options for MV disease, as much as one-half of patients with severe, symptomatic MR are not referred for surgery due to prohibitive procedural risk. Novel transcatheter alternatives are therefore being developed to provide an alternative treatment for these patients. A growing experience with transcatheter MV replacement (TMVR) strategies is accumulating and promising early results have been reported. However, the risk of transcatheter heart valve (THV) thrombosis seems to be relevant after TMVR, potentially higher than that observed after transcatheter aortic valve replacement, and routine anticoagulant therapy appears to be necessary to mitigate this risk. Hereafter, the authors: 1) review available evidence on thrombotic risk after TMVR (including new dedicated THVs for native MV, valve-in-valve, valve-in-ring, and valve-in-mitral annular calcification); and 2) discuss the antithrombotic treatment strategies after TMVR.

严重的二尖瓣关闭不全（MR）在普通人群中相当普遍，并且与明显的发病率和死亡率相关。尽管外科二尖瓣（MV）的修复和置换是针对MV疾病的行之有效的治疗选择，但是由于严重的程序风险，多达一半的患有严重症状性MR的患者并未接受手术治疗。因此，正在开发新颖的经导管替代物以为这些患者提供替代治疗。经导管MV替换（TMVR）策略的经验不断积累，并且已经报道了有希望的早期结果。但是，TMVR后经导管心脏瓣膜（THV）血栓形成的风险似乎是相关的，可能比经导管主动脉瓣置换后观察到的风险高，常规抗凝治疗似乎对于减轻这种风险是必要的。此后，作者：1）回顾了TMVR后血栓风险的可用证据（包括用于天然MV，瓣膜内瓣膜，瓣膜内瓣膜和瓣膜间瓣环钙化的新型专用THV）；2）讨论TMVR后的抗血栓治疗策略。