Thrombo-embolic prevention after transcatheter aortic valve implantation

Transcatheter aortic valve implantation (TAVI) has emerged as a valuable treatment alternative to surgical aortic valve replacement among patients with symptomatic aortic stenosis at increased surgical risk. The rapid technological evolution from early to current-generation TAVI systems with low-pro...

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Published inEuropean heart journal Vol. 38; no. 45; pp. 3341 - 3350
Main Authors Vranckx, Pascal, Windecker, Stephan, Welsh, Robert C, Valgimigli, Marco, Mehran, Roxana, Dangas, George
Format Journal Article
LanguageEnglish
Published England 01.12.2017
Subjects
Administration, Oral
Anticoagulants - therapeutic use
Aortic Valve Stenosis - surgery
Bioprosthesis
Fibrinolytic Agents - therapeutic use
Graft Occlusion, Vascular - etiology
Heart Valve Prosthesis
Humans
Myocardial Infarction - etiology
Myocardial Infarction - prevention & control
Postoperative Care
Postoperative Complications - prevention & control
Postoperative Hemorrhage - etiology
Practice Guidelines as Topic
Stroke - etiology
Thromboembolism - prevention & control
Transcatheter Aortic Valve Replacement - adverse effects
Transcatheter Aortic Valve Replacement - methods
Trauma, Nervous System - prevention & control
Vascular Closure Devices
Venous Thromboembolism - prevention & control
Aortic valve
Anticoagulation
TAVI
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Summary:Transcatheter aortic valve implantation (TAVI) has emerged as a valuable treatment alternative to surgical aortic valve replacement among patients with symptomatic aortic stenosis at increased surgical risk. The rapid technological evolution from early to current-generation TAVI systems with low-profile delivery catheters, bioprosthetic valves with proven midterm durability, and improved positioning and retrieval features have made important contributions to the widespread clinical use of this minimal invasive therapy. Although peri-procedural and long-term thrombotic and bleeding events after TAVI remain a relevant concern, the optimal antithrombotic strategy and duration to mitigate these risks remain unclear. This review provides an overview of recent insights in this field, and highlights current and future antithrombotic trials focusing on optimizing outcomes in patients undergoing TAVI.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
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ObjectType-Review-1
ISSN:0195-668X
1522-9645
DOI:10.1093/eurheartj/ehx390