Review Article
Volume 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
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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