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Intravascular Ultrasound and Angioscopy Assessment of Coronary Plaque Components in Chronic Totally Occluded Lesions Impact of Positive and Negative Lesion Site Remodeling on Clinical Outcomes : Insights From PROSPECT Transcatheter versus Surgical Aortic Valve Replacement in Patients with Prior Cardiac Surgery in the Randomized PARTNER 2A Trial Incidence and Outcomes of Surgical Bailout During TAVR : Insights From the STS/ACC TVT Registry Summary of Updated Recommendations for Primary Prevention of Cardiovascular Disease in Women: JACC State-of-the-Art Review Longitudinal Change in Galectin-3 and Incident Cardiovascular Outcomes Predictors of high residual gradient after transcatheter aortic valve replacement in bicuspid aortic valve stenosis The Evolution of β-Blockers in Coronary Artery Disease and Heart Failure (Part 1/5) Novel predictors of late lumen enlargement in distal reference segments after successful recanalization of coronary chronic total occlusion Noninvasive Nuclear SPECT Myocardial Blood Flow Quantitation to Guide Management for Coronary Artery Disease
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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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