Thrombotic Versus Bleeding Risk After Transcatheter Aortic Valve Replacement: JACC Review Topic of the Week

Antonio Mangieri, Claudio Montalto, Enrico Poletti, Alessandro Sticchi, Gabriele Crimi, Francesco Giannini, Azeem Latib, Davide Capodanno, Antonio Colombo

Research output: Contribution to journalReview article

Abstract

A large amount of evidence supports the widespread use of transcatheter aortic valve replacement (TAVR) among patients who are at low to intermediate risk for surgery. However, several controversies exist about the optimal antithrombotic regimen to use in these patients. On the one hand, concerns about ischemic stroke, subclinical leaflet thrombosis, valve thrombosis, and long-term durability suggest the need for a stronger antithrombotic regimen to ensure a better patient and valve outcome. On the other hand, the high bleeding risk of this population and the current lack of strong evidence in favor of a more aggressive antithrombotic strategy require caution. This review analyzes the rationale of antithrombotic therapy in TAVR illustrating the present scenario and future perspectives.

Original languageEnglish
Pages (from-to)2088-2101
Number of pages14
JournalJournal of the American College of Cardiology
Volume74
Issue number16
DOIs
Publication statusPublished - Oct 22 2019

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Keywords

  • anticoagulation
  • aortic stenosis
  • bleeding
  • direct oral anticoagulants
  • TAVR
  • transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Mangieri, A., Montalto, C., Poletti, E., Sticchi, A., Crimi, G., Giannini, F., Latib, A., Capodanno, D., & Colombo, A. (2019). Thrombotic Versus Bleeding Risk After Transcatheter Aortic Valve Replacement: JACC Review Topic of the Week. Journal of the American College of Cardiology, 74(16), 2088-2101. https://doi.org/10.1016/j.jacc.2019.08.1032