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Antithrombotic therapy for transcatheter structural heart intervention.

Paul Guedeney1, Josep Rodés-Cabau2, Jurriën M Ten Berg3,4

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Eurointervention : Journal of Europcr in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
|August 19, 2024
PubMed
Summary

Transcatheter structural heart interventions offer improved outcomes but carry thrombotic risks. This review examines device-related thrombosis and antithrombotic guidelines for these procedures.

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Biomaterials

Background:

  • Transcatheter structural heart interventions have surged, benefiting patients unsuitable for surgery.
  • These procedures include valve repair/implantation and septal defect/appendage occlusions.
  • Devices face blood flow, risking thrombosis and embolization in high-risk patients.

Purpose of the Study:

  • To review device-related thrombotic risks in transcatheter structural heart interventions.
  • To summarize current evidence-based guidelines for antithrombotic therapy.
  • To identify evidence gaps and ongoing trials in this field.

Main Methods:

  • State-of-the-art literature review.
  • Analysis of device-related thrombotic complications.
  • Evaluation of current antithrombotic treatment guidelines.

Main Results:

  • Transcatheter interventions present significant thrombotic risks.
  • Guidelines for antithrombotic treatment vary across procedures.
  • Specific evidence gaps and ongoing research were identified.

Conclusions:

  • Managing thrombotic risk is crucial for transcatheter structural heart interventions.
  • Further research is needed to optimize antithrombotic strategies.
  • Ongoing trials aim to address current evidence limitations.