Key result
Antithrombotic therapy for device-based transcatheter interventions requires a tailored approach to balance the risks of thrombotic and bleeding complications.
Why the study?
Balancing thrombotic and bleeding risks in patients undergoing structural heart disease transcatheter interventions remains challenging, and the optimal antithrombotic regimens for each specific procedure are unclear.
What is the optimal antithrombotic therapy for patients undergoing transcatheter interventions for structural heart disease to balance thromboembolic and bleeding risks?
What is the optimal antithrombotic therapy for patients undergoing transcatheter interventions for structural heart disease to balance thromboembolic and bleeding risks?
This review highlights the ongoing challenges in balancing thromboembolic and bleeding risks in patients undergoing structural heart interventions, advocating for tailored antithrombotic regimens.
Supports individualized antithrombotic strategies in transcatheter structural interventions; leaves open definitive regimen selection pending randomized trials.
Contemporary evidence supports device-based transcatheter interventions for the management of patients with structural heart disease. These procedures, which include aortic valve implantation, mitral or tricuspid valve repair/implantation, left atrial appendage occlusion, and patent foramen ovale closure, profoundly differ with respect to clinical indications and procedural aspects. Yet, patients undergoing transcatheter cardiac interventions require antithrombotic therapy before, during, or after the procedure to prevent thromboembolic events. However, these therapies are associated with an increased risk of bleeding complications. To date, challenges and controversies exist regarding balancing the risk of thrombotic and bleeding complications in these patients such that the optimal antithrombotic regimens to adopt in each specific procedure is still unclear. In this review, we summarize current evidence on antithrombotic therapies for device-based transcatheter interventions targeting structural heart disease and emphasize the importance of a tailored approach in these patients.
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Calabrò et al. (2021) conducted a review in Structural heart disease undergoing transcatheter interventions. Antithrombotic therapy was evaluated. Antithrombotic therapy for device-based transcatheter interventions requires a tailored approach to balance the risks of thrombotic and bleeding complications.
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