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Antithrombotic Therapy After Transcatheter Aortic Valve Replacement: An Overview
Mathew N Hindi1, Mariama Akodad1, Thomas Nestelberger1,2
1Centre for Cardiovascular and Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada.
Structural Heart : the Journal of the Heart Team
|June 8, 2023
Summary
Optimal antithrombotic therapy after transcatheter aortic valve replacement (TAVR) remains unclear. This review examines bleeding and clotting risks to guide antithrombotic strategies, aiming to reduce complications in elderly patients.
Area of Science:
- Cardiology
- Interventional Cardiology
- Geriatric Medicine
Background:
- Transcatheter aortic valve replacement (TAVR) effectively treats severe aortic stenosis.
- Optimal antithrombotic strategies post-TAVR are not well-defined.
- Patient factors like frailty and bleeding risk influence treatment decisions.
Purpose of the Study:
- To review thromboembolic and bleeding events following TAVR.
- To summarize evidence on antiplatelet and anticoagulant use post-TAVR.
- To highlight challenges and future research directions in TAVR antithrombotic therapy.
Main Methods:
- Literature review of studies on antithrombotic regimens post-TAVR.
- Analysis of thromboembolic and bleeding event data.
- Synthesis of current evidence and clinical guidelines.
Main Results:
- Significant variability exists in current antithrombotic practices post-TAVR.
- Evidence for specific antiplatelet or anticoagulant use is evolving.
- Balancing antithrombotic therapy is crucial to mitigate risks.
Conclusions:
- Further research is needed to establish optimal antithrombotic regimens post-TAVR.
- Personalized antithrombotic strategies are essential for frail, elderly TAVR patients.
- Improved understanding can minimize morbidity and mortality.
Keywords:
Antiplatelet therapyAntithrombotic therapyOral anticoagulationTranscatheter aortic valve replacementMore Related Videos
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