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

doi:10.1016/j.jacc.2019.08.1032

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 journal › Review article › peer-review

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 language	English
Pages (from-to)	2088-2101
Number of pages	14
Journal	Journal of the American College of Cardiology
Volume	74
Issue number	16
DOIs	https://doi.org/10.1016/j.jacc.2019.08.1032
Publication status	Published - Oct 22 2019

Keywords

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

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

Access to Document

10.1016/j.jacc.2019.08.1032

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Thrombotic Versus Bleeding Risk After Transcatheter Aortic Valve Replacement : JACC Review Topic of the Week. / Mangieri, Antonio; Montalto, Claudio; Poletti, Enrico; Sticchi, Alessandro; Crimi, Gabriele; Giannini, Francesco; Latib, Azeem; Capodanno, Davide; Colombo, Antonio.

In: Journal of the American College of Cardiology, Vol. 74, No. 16, 22.10.2019, p. 2088-2101.

Research output: Contribution to journal › Review article › peer-review

Mangieri, Antonio ; Montalto, Claudio ; Poletti, Enrico ; Sticchi, Alessandro ; Crimi, Gabriele ; Giannini, Francesco ; Latib, Azeem ; Capodanno, Davide ; Colombo, Antonio. / Thrombotic Versus Bleeding Risk After Transcatheter Aortic Valve Replacement : JACC Review Topic of the Week. In: Journal of the American College of Cardiology. 2019 ; Vol. 74, No. 16. pp. 2088-2101.

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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.",

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