Antithrombotic Treatment After Transcatheter Valve Interventions: Current Status and Future Directions

Clinical Therapeutics, Journal Year: 2023, Volume and Issue: 46(2), P. 122 - 133

Published: Nov. 4, 2023

PurposeThe optimal antithrombotic strategy after transcatheter valve interventions is a subject of ongoing debate. Although there evidence from randomized trials in patients undergoing aortic replacement (TAVR), current on management mitral or tricuspid sparse. This article appraises the this topic.MethodsThis narrative review presents key research findings and guideline recommendations, as well highlights areas for future research.FindingsAfter TAVR, trial suggests that single antiplatelet therapy reasonable without pre-existing indications oral anticoagulation (OAC). If concurrent indication OAC, addition increases bleeding risk. Whether direct anticoagulants achieve better outcomes than vitamin K antagonists uncertain setting. OAC has been shown to reduce subclinical leaflet thrombosis (which may progress structural degeneration), events are unacceptably high. There lack data comparing strategies edge-to-edge repair. Single repair be appropriate, whereas at least 3 months suggested replacement.ImplicationsRandomized studies warranted address knowledge gaps optimize outcomes.

Language: Английский

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Surgical versus transcatheter aortic valve replacement in low-risk Medicare beneficiaries

Journal of Thoracic and Cardiovascular Surgery, Journal Year: 2024, Volume and Issue: unknown

Published: April 1, 2024

Language: Английский

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Long-term prosthetic-associated subclinical thrombotic events evaluation by cardiac CTA after transcatheter aortic valve implantation: incidence and outcomes

Insights into Imaging, Journal Year: 2024, Volume and Issue: 15(1)

Published: May 30, 2024

Abstract Objective To observe prosthetic-associated subclinical thrombotic events (PASTE) after transcatheter aortic valve implantation (TAVI) by cardiac CTA, and assess their impact on long-term patient outcomes. Materials We prospectively consecutively enrolled 188 patients with severe stenosis treated TAVI from February 2014 to April 2017. At 5 years, 61 of 141 survived who had completed annual follow-up CTA (≥ years) were included. analyzed PASTE including hypoattenuated leaflet thickening (HALT), sinus filling defect (SFD), prosthesis (PFD). The primary outcome was a major adverse cardiovascular composite (MACCO) stroke, re-hospitalization, bioprosthetic dysfunction (BVD); the secondary outcomes hemodynamics deterioration (PGmean) (LVEF). Results During median time 5.25 incidence HALT, SFD, PFD 54.1%, 37.7%, 73.8%, respectively. In outcome, SFD early associated MACCO (SFD: p = 0.005; SFD: 0.018), predictor (HR: 2.870; 95% CI: 1.010 8.154, 0.048). outcomes, HALT increased PGmean ( 0.031), while persistent correlated ΔPGmean (β 0.38, 0.035). negatively ΔLVEF −0.39, 0.041), LVEF (LVEF: r −0.50, 0.041; ΔLVEF: −0.53, 0.030). Conclusions deterioration, dysfunction. particular, may be potential target for anticoagulation (NCT02803294). Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02803294. Critical relevance statement PASTE, especially based findings impacts which is in TAVI. Key Points Transcatheter being used more often; thromboses have not been thoroughly evaluated. Prosthetic-associated Studies should directed at these topics determine if they intervened upon. Graphical

Language: Английский

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What Is the Optimal Antithrombotic Therapy for Valsalva Thrombus Following Transcatheter Aortic Valve Replacement?

JACC Case Reports, Journal Year: 2024, Volume and Issue: 29(16), P. 102455 - 102455

Published: Aug. 1, 2024

Thrombus formation between the native sinus of Valsalva and implanted transcatheter heart valve is a rare complication that may be associated with an increased risk for thrombotic complications. This paper presents course 3 cases thrombus, focus on management antithrombotic therapy.

Language: Английский

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Prospective study on the impact of different anti-thrombotic therapies on subclinical leaflet thickening and its temporal dynamics in transcatheter aortic valves - The NOTION-4 trial

American Heart Journal, Journal Year: 2024, Volume and Issue: 279, P. 1 - 8

Published: Oct. 5, 2024

Language: Английский

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