Key result
Review outlines optimal antithrombotic strategies and ongoing randomized trials following TAVI.
Why the study?
Current antithrombotic strategies after TAVI are empiric and based on expert consensus extrapolated from PCI, lacking direct evidence specific to TAVI patients.
What is the optimal antithrombotic management strategy after transcatheter aortic valve implantation?
What is the optimal antithrombotic management strategy after transcatheter aortic valve implantation?
This review summarizes the rationale, current guidelines, and ongoing randomized trials regarding antithrombotic management strategies following TAVI.
Transcatheter aortic valve implantation (TAVI) is now the accepted standard of care for patients with symptomatic severe aortic stenosis at elevated risk for conventional surgical valve replacement. Currently, societal guidelines propose the use of dual antiplatelet therapy for the prevention of thromboembolic events after TAVI in patients without an indication for oral anticoagulation. This strategy is empiric and largely based on expert consensus extrapolated from the arena of percutaneous coronary intervention. In this review, we explore the rational for using antiplatelet and/or anticoagulant strategies after TAVI, review current guidelines and the evidence underpinning them, and detail the on-going randomized trials that will shape future recommendations on this important issue.
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McHugh et al. (2018) conducted a review in Symptomatic severe aortic stenosis. Antithrombotic management (antiplatelet and/or anticoagulant strategies) was evaluated. This review explores the rationale, current guidelines, and ongoing randomized trials for antiplatelet and anticoagulant strategies after transcatheter aortic valve implantation.
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