Title:Antithrombotic Therapy for Transcatheter Valvular Interventions: A Revisit
Volume: 16
Issue: 2
Author(s): Shaban Mohammed, Ayman El-Menyar*, Haifa Al-Janubi, Adel Shabana and Zaid Alanazi
Affiliation:
- Clinical Medicine, Weill Cornell Medical College, Doha,Qatar
Keywords:
TAVI, MitraClip, aortic stenosis, SAVR, antiplatelet, antithrombotic.
Abstract: Background: The optimal antithrombotic therapies for transcatheter aortic valve implantation
(TAVI) and MitraClip implantation have not been well established. We conducted a narrative review
from currently available studies between January 2002 and May 2016 to highlight the advantages and
disadvantages of antithrombotic therapy use in cardiac catheter-based therapeutic techniques. Recently,
these techniques have dramatically altered the approach towards valvular heart diseases management.
The introduction into clinical practice, of TAVI for severe aortic stenosis and MitraClip for mitral regurgitation,
has revolutionized interventional cardiology. However, TAVI is associated with a risk of
cerebral embolization and ischaemic vascular events leading to neurological impairment and even death.
These ischaemic complications might occur perioperatively or much later, although the estimated rate of
occurrence is variable.
Conclusion: We will discuss prior experience with MitraClip for antithrombotic use. It is imperative for
patients undergoing transcatheter valvular interventions to have optimal antithrombotic therapy that
balances between ischaemic and haemorrhagic complications. The appropriate timing, combination, and
duration of antithrombotic medications need consensus to weigh between the efficacy, efficiency and
adverse effects in patients with transcatheter valvular interventions.
