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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
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Bleeding Events After Transcatheter Aortic Valve Replacement: JACC State-of-the-Art Review

Marisa Avvedimento1, Jorge Nuche1, Julio I Farjat-Pasos1

  • 1Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada.

Journal of the American College of Cardiology
|February 15, 2023
PubMed

Insights

Transcatheter aortic valve replacement (TAVR) reduces complications, but bleeding remains a risk. Tailored antithrombotic strategies are crucial for preventing bleeding events in TAVR patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Transcatheter aortic valve replacement (TAVR) has seen significant reductions in procedural complications.
  • Clinically relevant bleeding remains a concern post-TAVR, negatively impacting patient outcomes.
  • Patients undergoing TAVR, often elderly with comorbidities, face heightened bleeding risks.

Purpose of the Study:

  • To provide a comprehensive review of bleeding events in the context of TAVR.
  • To discuss the definitions, risk factors, timing, and clinical impact of bleeding after TAVR.
  • To update on antithrombotic management strategies and their influence on bleeding complications.

Main Methods:

  • Literature review focusing on bleeding events and antithrombotic management in TAVR.
  • Analysis of risk factors, including patient demographics, comorbidities, and procedural elements.
  • Evaluation of current and emerging antithrombotic strategies for bleeding prevention.

Main Results:

  • Despite TAVR advancements, bleeding complications persist in a significant patient proportion.
  • Advanced age, high comorbidity burden, procedural factors, and antithrombotic therapy contribute to bleeding risk.
  • A tailored, individualized approach to antithrombotic management is essential for mitigating bleeding events.

Conclusions:

  • Bleeding prevention is a critical area for improving patient care after TAVR.
  • Balancing hemorrhagic and ischemic risks requires personalized antithrombotic strategies.
  • Preprocedural evaluation and optimized antithrombotic regimens are key to reducing TAVR-associated bleeding.

Keywords:
TAVRbleedingtranscatheter aortic valve replacement

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