August 1, 2024EuroIntervention9 citationsOpen Access
Antithrombotic therapy for transcatheter structural heart intervention
Key Result
This state-of-the-art review summarizes device-related thrombotic risks and current evidence-based guidelines for antithrombotic treatments in transcatheter structural heart interventions.
Structured PICO
P
Population
Patients undergoing transcatheter structural heart interventions (including valve implantation or repair, and occlusions of the patent foramen ovale, atrial septal defects, and left atrial appendage)
I
Intervention
Antithrombotic treatments
This state-of-the-art review provides a comprehensive overview of thrombotic risks and current evidence-based antithrombotic management strategies for patients undergoing transcatheter structural heart interventions.
Abstract
Percutaneous transcatheter structural heart interventions have considerably expanded within the last two decades, improving clinical outcomes and quality of life versus guideline-directed medical therapy for patients frequently ineligible for surgical treatment. Transcatheter structural heart interventions comprise valve implantation or repair and also occlusions of the patent foramen ovale, atrial septal defects and left atrial appendage. These procedures expose structural devices to arterial or venous blood flow with various rheological conditions leading to potential thrombotic complications and embolisation. Furthermore, these procedures may concern comorbid patients at high risk of both ischaemic and bleeding complications. This state-of-the-art review provides a description of the device-related thrombotic risk associated with these transcatheter structural heart interventions and of the current evidence-based guidelines regarding antithrombotic treatments. Gaps in evidence for each of the studied transcatheter interventions and the main ongoing trials are also summarised.