Title:Novel Perspective for Antithrombotic Therapy in TAVI
Volume: 26
Issue: 23
Author(s): Maria Drakopoulou, Stergios Soulaidopoulos, George Oikonomou, Konstantinos Stathogiannis, George Latsios, Andreas Synetos, Dimitrios Tousoulis and Konstantinos Toutouzas*
Affiliation:
- First Department of Cardiology, Hippokration Hospital, Medical School of Athens University, Athens,Greece
Keywords:
TAVI, antithrombotic therapy, DAPT, NOAC, VKA, SAVR.
Abstract: While surgical aortic valve replacement (SAVR) was for years the only available treatment for symptomatic
aortic stenosis, the introduction of transcatheter aortic valve implantation (TAVI) in 2002 and the improvement
of its technical aspects in the following years, has holistically changed the synchronous therapeutic
approach of aortic valve stenosis. Recent evidence has expanded the indication of TAVI from high to lower surgical
risk populations with symptomatic aortic stenosis. The administration of antithrombotic therapy periprocedurally
and its maintenance after a successful TAVI is crucial for the prevention of complications and affects
postprocedural survival. Randomized controlled trials investigating the appropriate combination and the
duration of antithrombotic treatment after TAVI are for the moment scarce. This review article sheds light on the
underlying pathogenetic mechanisms contributing in periprocedural TAVI thrombotic complications and discuss
the efficacy of current antithrombotic policies as evaluated in randomized trials.