Review article
https://doi.org/10.21860/medflum2024_316226
Antithrombotic Therapy after the Transcatheter Aortic Valve Implantation
Davorka Lulić
; Klinički bolnički centar Rijeka, Klinika za bolesti srca i krvnih žila, Rijeka, Hrvatska
*
Luka Košak
; Nastavni zavod za hitnu medicinu Istarske županije, Pula, Hrvatska
Gordana Bačić
; Klinički bolnički centar Rijeka, Klinika za bolesti srca i krvnih žila, Rijeka, Hrvatska
Zoran Miovski
; Klinički bolnički centar Rijeka, Klinika za bolesti srca i krvnih žila, Rijeka, Hrvatska
Tomislav Jakljević
; Klinički bolnički centar Rijeka, Klinika za bolesti srca i krvnih žila, Rijeka, Hrvatska
Vjekoslav Tomulić
; Klinički bolnički centar Rijeka, Klinika za bolesti srca i krvnih žila, Rijeka, Hrvatska
* Corresponding author.
Abstract
Aortic stenosis (AS) is the most common primary valvular heart disease. Severe symptomatic aortic stenosis should be treated surgically or percutaneously. Transcatheter aortic valve implantation (TAVI) is a percutaneous method that has become a choice of treatment in many patients in the past 20 years, according to the decision of the Heart Team. The period during and after the procedure is extremely important to prevent the onset of thromboembolic complications. 7% of patients experience an ischemic stroke in the first 12 months after the TAVI procedure. Postprocedurally, the stroke is most often caused by new atrial fibrillation onset or thrombosis of the bioprosthesis. Antithrombotic therapy is the therapy of choice for preventing thromboembolic events after the TAVI procedure. On the other hand, iatrogenic bleeding complications can occur in the early postoperative period. The type of antithrombotic therapy after the TAVI procedure differs depending on the presence of chronic anticoagulant therapy. In patients without an indication for chronic anticoagulant therapy, acetylsalicylic acid is the drug of choice, while in patients with an indication for anticoagulant therapy, oral anticoagulants should be prescribed. Thrombocytopenia is a common complication after TAVI. In these patients or in those with chronic thrombocytopenia, the type and duration of antithrombotic therapy depend on the severity of thrombocytopenia. Those patients should be discussed with the multidisciplinary team of cardiologists and hematologists, taking into consideration ischemic and bleeding risks.
Keywords
Anticoagulants; Aortic Valve Stenosis; Platelet Aggregation Inhibitors; Thrombocytopenia; Transcatheter Aortic Valve Replacement
Hrčak ID:
316226
URI
Publication date:
1.6.2024.
Visits: 739 *