TY - JOUR
T1 - Thrombotic Versus Bleeding Risk After Transcatheter Aortic Valve Replacement
T2 - JACC Review Topic of the Week
AU - Mangieri, Antonio
AU - Montalto, Claudio
AU - Poletti, Enrico
AU - Sticchi, Alessandro
AU - Crimi, Gabriele
AU - Giannini, Francesco
AU - Latib, Azeem
AU - Capodanno, Davide
AU - Colombo, Antonio
PY - 2019/10/22
Y1 - 2019/10/22
N2 - 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.
AB - 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.
KW - anticoagulation
KW - aortic stenosis
KW - bleeding
KW - direct oral anticoagulants
KW - TAVR
KW - transcatheter aortic valve replacement
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U2 - 10.1016/j.jacc.2019.08.1032
DO - 10.1016/j.jacc.2019.08.1032
M3 - Review article
AN - SCOPUS:85072831155
VL - 74
SP - 2088
EP - 2101
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 16
ER -