Antithrombotic treatment after surgical and transcatheter heart valve interventions requires a tailored approach based on valve type, position, and patient-specific thromboembolic and bleeding risks.
Systematic Review
This paper provides a multidisciplinary consensus on antithrombotic management following surgical and transcatheter valve interventions, addressing gaps and divergences in current major guidelines.
New antithrombotic drugs have been developed, new valve types have been designed and minimally invasive transcatheter techniques have emerged, making the choice of antithrombotic therapy after surgical or transcatheter heart valve repair and replacement increasingly complex. Moreover, due to a lack of large randomized controlled trials many recommendations for antithrombotic therapy are based on expert opinion, reflected by divergent recommendations in current guidelines. Therefore, decision-making in clinical practice regarding antithrombotic therapy for prosthetic heart valves is difficult, potentially resulting in sub-optimal patient treatment. This article compares the 2017 ESC/EACTS and 2020 ACC/AHA guidelines on the management of valvular heart disease and summarizes the available evidence. Finally, we established a convenient consensus on antithrombotic therapy after valve interventions based on over 800 annual cases of surgical and transcatheter heart valve repair and replacement and a multidisciplinary team discussion between the department of cardiovascular diseases and cardiac surgery of the University Hospitals Leuven, Belgium.
Verstraete et al. (Thu,) conducted a systematic review in Valvular heart disease. Antithrombotic therapy was evaluated. Antithrombotic treatment after surgical and transcatheter heart valve interventions requires a tailored approach based on valve type, position, and patient-specific thromboembolic and bleeding risks.
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