Antithrombotic therapy in patients undergoing transcatheter aortic valve replacement (TAVR): from current evidence to perspective

Abstract

The use of transcatheter aortic valve replacement (TAVR) for care of symptomatic severe aortic stenosis has increased over the last years; after initially treating patients at prohibitive or high surgical risk, nowadays the procedure can be considered for intermediate or low surgical risk. Although thrombotic events (ischemic stroke, myocardial infarction, and leaflet thrombosis) decreased in patients at lower risk, antithrombotic therapy after TAVR is still recommended. However, the optimal antithrombotic regimen is a still matter of debate due to the lack of randomized data and the concomitant increased risk of bleeding events. In the present review, we analyze current data, recommendations of international guidelines and consensus documents, and potential future scenarios with a rational approach of separation of patients with or without a pre-procedural indication for long-term oral anticoagulant therapy.

Keywords

Antiplatelet / anticoagulant / transcatheter aortic valve replacement

References

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