Antithrombotic Therapy in Patients Undergoing Transcatheter Interventions for Structural Heart Disease. Issue 16 (19th October 2021)

• Record Type: Journal Article
• Authors: Calabrò, Paolo; Gragnano, Felice; Niccoli, Giampaolo; Marcucci, Rossella; Zimarino, Marco; Spaccarotella, Carmen; Renda, Giulia; Patti, Giuseppe; Andò, Giuseppe; Moscarella, Elisabetta; Mancone, Massimo; Cesaro, Arturo; Giustino, Gennaro; De Caterina, Raffaele; Mehran, Roxana; Capodanno, Davide; Valgimigli, Marco; Windecker, Stephan; Dangas, George D.; Indolfi, Ciro; Angiolillo, Dominick J.
• Other Names: other.
• Is Part Of: Circulation. Volume 144:Issue 16(2021)
• Page Start: 1323
• Page End: 1343
• Publication Date: 2021-10-19
• Subjects: anticoagulants -- atrial appendage -- atrial fibrillation -- foramen ovale, patent -- mitral valve -- thrombosis -- transcatheter aortic valve replacement; Blood -- Circulation -- Periodicals; Cardiovascular system -- Periodicals; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; Blood Circulation; Cardiovascular System; Vascular Diseases; 616.1
• DOI: 10.1161/CIRCULATIONAHA.121.054305
• Languages: English
• ISSNs: 0009-7322

Abstract

Abstract : Supplemental Digital Content is available in the text. Abstract : Contemporary evidence supports device-based transcatheter interventions for the management of patients with structural heart disease. These procedures, which include aortic valve implantation, mitral or tricuspid valve repair/implantation, left atrial appendage occlusion, and patent foramen ovale closure, profoundly differ with respect to clinical indications and procedural aspects. Yet, patients undergoing transcatheter cardiac interventions require antithrombotic therapy before, during, or after the procedure to prevent thromboembolic events. However, these therapies are associated with an increased risk of bleeding complications. To date, challenges and controversies exist regarding balancing the risk of thrombotic and bleeding complications in these patients such that the optimal antithrombotic regimens to adopt in each specific procedure is still unclear. In this review, we summarize current evidence on antithrombotic therapies for device-based transcatheter interventions targeting structural heart disease and emphasize the importance of a tailored approach in these patients.