Management of antithrombotic therapy in patients undergoing transcatheter aortic valve implantation: a consensus document of the ESC Working Group on Thrombosis and the European Association of Percutaneous Cardiovascular Interventions (EAPCI), in collaboration with the ESC Council on Valvular Heart Disease

Author:

ten Berg Jurrien12ORCID,Sibbing Dirk345,Rocca Bianca6ORCID,Van Belle Eric7,Chevalier Bernard8,Collet Jean-Philippe9ORCID,Dudek Dariusz1011,Gilard Martine12,Gorog Diana A1314ORCID,Grapsa Julia15ORCID,Grove Erik Lerkevang16ORCID,Lancellotti Patrizio1718,Petronio Anna Sonia19,Rubboli Andrea20,Torracca Lucia21,Vilahur Gemma22,Witkowski Adam23,Mehilli Julinda4524

Affiliation:

1. Department of Cardiology and Center for Platelet Function Research, St Antonius Hospital, Nieuwegein, the Netherlands

2. The Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands

3. Privatklinik Lauterbacher Mühle am Ostersee, Seeshaupt, Germany

4. Department of Cardiology, Ludwig-Maximilians-Universität München (LMU Munich), Munich, Germany

5. DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany

6. Institute of Pharmacology, Catholic University School of Medicine, Rome, Italy

7. Department of Interventional Cardiology for Coronary, Valves and Structural Heart Diseases, CHU Lille, Institut Coeur Poumon, Cardiology, INSERM U1011, Institut Pasteur de Lille, Lille, France

8. Ramsay Générale de Santé, ICPS, Hôpital Jacques Cartier, Massy, France

9. ACTION Study Group, Institut De Cardiologie, Hôpital Pitié-Salpêtrière (APHP), Sorbonne Université, Paris, France

10. Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland

11. Maria Cecilia Hospital, GVM Care&Research, Cotignola (RA), Italy

12. Department of Cardiology, La Cavale Blanche University Hospital Center, Optimization of Physiological Regulations, Science and Technical Training and Research Unit, University of Western Brittany, Brest, France

13. National Heart & Lung Institute, Imperial College, London, UK

14. Postgraduate Medical School, University of Hertfordshire, Hertfordshire, UK

15. Department of Cardiology, Guys and St Thomas NHS Hospitals, London, UK

16. Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

17. University of Liège Hospital, GIGA Cardiovascular Sciences, Department of Cardiology, CHU Sart Tilman, Liège, Belgium

18. Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, and Anthea Hospital, Bari, Italy

19. Department of Cardiology, University of Pisa, Pisa, Italy

20. Department of Cardiovascular Diseases-AUSL Romagna, Division of Cardiology, Ospedale S. Maria delle Croci, Ravenna, Italy

21. Department of Cardiac Surgery, Humanitas University Hospital Rozzano-Milano, Italy

22. Cardiovascular Program-ICCC, IR-Hospital de la Santa Creu i Sant Pau, CiberCV, Autonomous University of Barcelona, Spain

23. Department of Interventional Cardiology and Angiology, National Institute of Cardiology Cardiology, Warsaw, Poland

24. Department of Cardiology, Medizinische Klinik I, Landshut-Achdorf Hospital, Landshut, Germany

Abstract

Abstract Transcatheter aortic valve implantation (TAVI) is effective in older patients with symptomatic severe aortic stenosis, while the indication has recently broadened to younger patients at lower risk. Although thromboembolic and bleeding complications after TAVI have decreased over time, such adverse events are still common. The recommendations of the latest 2017 ESC/EACTS Guidelines for the management of valvular heart disease on antithrombotic therapy in patients undergoing TAVI are mostly based on expert opinion. Based on recent studies and randomized controlled trials, this viewpoint document provides updated therapeutic insights in antithrombotic treatment during and after TAVI.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine

Reference15 articles.

1. 2017 ESC/EACTS Guidelines for the management of valvular heart disease;Baumgartner;Eur Heart J,2017

2. 2020 ACC/AHA Guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines;Otto;Circulation,2021

3. A controlled trial of rivaroxaban after transcatheter aortic-valve replacement;Dangas;N Engl J Med,2020

4. Anticoagulation with or without clopidogrel after transcatheter aortic-valve implantation;Nijenhuis;N Engl J Med,2020

5. Aspirin with or without clopidogrel after transcatheter aortic-valve implantation;Brouwer;N Engl J Med,2020

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