Antithrombotic Therapy in Patients Undergoing Transcatheter Interventions for Structural Heart Disease.
Paolo CalabròFelice GragnanoGiampaolo NiccoliRossella MarcucciMarco ZimarinoCarmen SpaccarotellaGiulia RendaGiuseppe PattiGiuseppe AndòElisabetta MoscarellaMassimo ManconeArturo CesaroGennaro GiustinoRaffaele De CaterinaRoxana MehranDavide CapodannoMarco ValgimigliStephan WindeckerGeorge D DangasCiro IndolfiDominick J AngiolilloPublished in: Circulation (2021)
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.
Keyphrases
- aortic valve
- atrial fibrillation
- patients undergoing
- aortic stenosis
- ejection fraction
- left atrial appendage
- end stage renal disease
- physical activity
- mitral valve
- newly diagnosed
- transcatheter aortic valve replacement
- chronic kidney disease
- left atrial
- transcatheter aortic valve implantation
- prognostic factors
- left ventricular
- risk factors
- stem cells
- mesenchymal stem cells
- coronary artery disease
- cell therapy
- patient reported