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Abstract

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Transcatheter Aortic Valve Replacement in Patients With Multivalvular Heart Disease Comparison of Early Surgical or Transcatheter Aortic Valve Replacement Versus Conservative Management in Low-Flow, Low-Gradient Aortic Stenosis Using Inverse Probability of Treatment Weighting: Results From the TOPAS Prospective Observational Cohort Study A Controlled Trial of Rivaroxaban After Transcatheter Aortic-Valve Replacement Anticoagulation After Surgical or Transcatheter Bioprosthetic Aortic Valve Replacement Right ventricular function and outcome in patients undergoing transcatheter aortic valve replacement Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk Patients Anticoagulation with or without Clopidogrel after Transcatheter Aortic-Valve Implantation Contemporary Presentation and Management of Valvular Heart Disease: The EURObservational Research Programme Valvular Heart Disease II Survey
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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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