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Updated: Sep 6, 2025
06:02
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
172
Antithrombotic Therapy after Transcatheter Aortic Valve Replacement.
Tariq A M Mousa1, Ahmed Mahfouz2, Nazar Mohammed1
1Department of Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
Summary
Optimal antithrombotic therapy after transcatheter aortic valve replacement (TAVR) is crucial. For patients without prior indications, single-antiplatelet therapy is preferred over dual-antiplatelet therapy to minimize bleeding risks.
Area of Science:
- Cardiology
- Interventional Cardiology
- Thrombosis Research
Background:
- Transcatheter aortic valve replacement (TAVR) is indicated for severe aortic stenosis in high-risk patients.
- TAVR procedures increase risks of thrombotic and bleeding complications.
- Elderly TAVR patients often have comorbidities like atrial fibrillation (AF) and coronary artery disease, necessitating anticoagulation and antiplatelet therapy.
Purpose of the Study:
- To review optimal antithrombotic strategies post-TAVR.
- To evaluate risks and benefits of different antithrombotic regimens.
- To guide clinical decision-making for TAVR patients.
Main Methods:
- Review of published literature and clinical studies.
- Analysis of antithrombotic therapy outcomes in TAVR patients.
- Comparison of single vs. dual antiplatelet therapy and oral anticoagulants (OACs).
Main Results:
- Dual-antiplatelet therapy post-TAVR (without baseline OAC indication) increases bleeding risk compared to single-antiplatelet therapy.
- Oral anticoagulation in TAVR patients without prior indication shows high bleeding hazard.
- Adding antiplatelet therapy to OACs in patients with AF increases bleeding events.
Conclusions:
- Single-antiplatelet therapy is a reasonable strategy for TAVR patients without baseline OAC indications.
- Oral anticoagulation is appropriate for TAVR patients with indications like AF.
- The net benefit of combined antiplatelet and OAC therapy remains unproven.
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