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Antiplatelet therapy in valvular and structural heart disease interventions
Annunziata Nusca1, Edoardo Bressi1, Iginio Colaiori1
1Unit of Cardiac Sciences, Campus Bio-Medico University of Rome, Rome, Italy.
Cardiovascular Diagnosis and Therapy
|December 1, 2018
Summary
Transcatheter heart procedures are advancing, but balancing blood clot and bleeding risks is crucial. This review covers antithrombotic strategies for transcatheter aortic valve implantation (TAVI) and other structural interventions.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiovascular Medicine
Background:
- Transcatheter interventions for valvular and structural heart diseases are rapidly expanding.
- These procedures offer a crucial alternative for patients with prohibitive surgical risk.
- Significant thrombotic and bleeding complications necessitate careful antithrombotic management.
Purpose of the Study:
- To review current data on antithrombotic management for key transcatheter procedures.
- To highlight the critical balance between thrombotic and bleeding risks in these patients.
Main Methods:
- Literature review of current data on antithrombotic strategies.
- Focus on transcatheter aortic valve implantation (TAVI).
- Inclusion of percutaneous mitral valve repair (MitraClip), left atrial appendage occlusion, and PFO/ASD closure.
Main Results:
- Transcatheter interventions are increasingly safe and effective.
- Antithrombotic management is complex due to dual risks.
- Specific strategies vary by procedure and patient profile.
Conclusions:
- Optimizing antithrombotic therapy is essential for favorable outcomes in transcatheter structural heart interventions.
- Further research is needed to refine antithrombotic protocols for TAVI, MitraClip, LAAO, and PFO/ASD closure.
- Individualized patient assessment is key to managing thrombotic and bleeding risks.
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