Antithrombotic Therapy in TAVI

Overview

Journal J Geriatr Cardiol

Specialty Geriatrics

Date 2018 Feb 14

PMID 29434628

Citations 6

Authors

Manolis Vavuranakis

Konstantinos Kalogeras

Angelos Michail Kolokathis

Dimitrios Vrachatis

Nikolaos Magkoutis

Gerasimos Siasos

Euaggelos Oikonomou

Maria Kariori

Theodoros Papaioannou

Maria Lavda

Carmen Moldovan

Ourania Katsarou

Dimitrios Tousoulis

Affiliations

Soon will be listed here.

Abstract

Transcatheter aortic valve implantation (TAVI) carries a significant thromboembolic and concomitant bleeding risk, not only during the procedure but also during the periprocedural period. Many issues concerning optimal antithrombotic therapy after TAVI are still under debate. In the present review, we aimed to identify all relevant studies evaluating antithrombotic therapeutic strategies in relation to clinical outcomes after the procedure. Four randomized control trials (RCT) were identified analyzing the post-TAVI antithrombotic strategy with all of them utilizing aspirin lifelong plus clopidogrel for 3-6 months. Seventeen registries have been identified, with a wide variance among them regarding baseline characteristics, while concerning antiplatelet therapy, clopidogrel duration was ranging from 3-12 months. Four non-randomized trials were identified, comparing single . dual antiplatelet therapy after TAVI, in respect of investigating thromboembolic outcome events over bleeding complications. Finally, limited data from a single RCT and a retrospective study exist with regards to anticoagulant treatment during the procedure and the optimal antithrombotic therapy when concomitant atrial fibrillation. In conclusion, due to the high risk and frailty of the treated population, antithrombotic therapy after TAVI should be carefully evaluated. Diminishing ischaemic and bleeding complications remains the main challenge in these patients with further studies to be needed in this field.

Citing Articles

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Risk of Bleeding after Transcatheter Aortic Valve Replacement: impact of Preoperative Antithrombotic Regimens.

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Antithrombotic therapy in patients undergoing transcatheter aortic valve replacement: the complexity of the elderly.

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Acute myocardial infarction associated with prosthetic valve leaflet thrombosis after transcatheter aortic valve implantation: a case report.

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Use of Dexmedetomidine in Transfemoral Transcatheter Aortic Valve Implantation (tf-TAVI) Procedures.

Cristiano L, Coppolino F, Donatiello V, Paladini A, Sansone P, Passavanti M Adv Ther. 2020; 37(5):2337-2343.

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