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Transcatheter Aortic Valve Replacement

Abstract

Recommended Article

2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines Transcatheter or Surgical Aortic-Valve Replacement in Intermediate-Risk Patients Surgical or Transcatheter Aortic-Valve Replacement in Intermediate-Risk Patients Evolving concepts in the management of antithrombotic therapy in patients undergoing transcatheter aortic valve implantation Feasibility of Coronary Access and Aortic Valve Reintervention in Low-Risk TAVR Patients Low Transvalvular Flow Rate Predicts Mortality in Patients With Low-Gradient Aortic Stenosis Following Aortic Valve Intervention Health Status after Transcatheter vs. Surgical Aortic Valve Replacement in Low-Risk Patients with Aortic Stenosis Coronary Access After TAVR With a Self-Expanding Bioprosthesis: Insights From Computed Tomography
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Review ArticleVolume 74, Issue 16, October 2019

JOURNAL：J Am Coll Cardiol. Article Link

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

A Mangieri, C Montalto, E Poletti et al. Keywords: anticoagulation; aortic stenosis; bleeding direct oral anticoagulants; TAVR; transcatheter aortic valve replacement

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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