Antithrombotic therapy with Transcatheter aortic valve replacement.

Area of Science:

• Cardiology
• Interventional Cardiology
• Valvular Heart Disease

Background:

• Severe aortic stenosis necessitates aortic valve replacement.
• Transcatheter aortic valve replacement (TAVR) now surpasses traditional surgical aortic valve replacement in frequency.
• TAVR devices differ from surgical valves, requiring distinct antithrombotic therapy considerations.

Purpose of the Study:

• To review current recommendations and evolving evidence for antithrombotic therapy in TAVR patients.
• To highlight the challenges in extrapolating data from surgical valve replacements.
• To inform clinicians on managing antithrombotic therapy in the context of TAVR.

Main Methods:

• Review of current literature and practice guidelines on antithrombotic therapy post-TAVR.
• Analysis of factors influencing antithrombotic agent selection.
• Discussion of subclinical valve thrombosis in TAVR patients.

Main Results:

• Antithrombotic therapy recommendations for TAVR are not directly transferable from surgical valve data.
• Patient-specific factors significantly influence the choice of antithrombotic agents.
• Subclinical valve thrombosis is common in TAVR patients, with evolving clinical implications.

Conclusions:

• Understanding evolving evidence and guidelines for antithrombotic therapy is crucial for clinicians treating TAVR patients.
• The clinical significance of subclinical valve thrombosis post-TAVR requires further investigation.
• Personalized antithrombotic strategies are essential for optimal TAVR outcomes.