Abstract
Transcatheter heart valve replacement technology was introduced as alternative to
surgery for the growing high-risk profile population. Developed first, aortic valve
replacement (TAVR) became a standard of care for patients with severe aortic stenosis
at high operative risk, with a potential future use also for low-risk subjects. In
the last decade, a multitude of transcatheter mitral valve replacement (TMVR) devices
have been developed for the treatment of severe mitral regurgitation, with encouraging
results coming from first-in-man and feasibility studies. As for biological surgical-type
valves, transcatheter implanted valves still preserve the risk of thrombosis and embolic
events and anticoagulation- or antiplatelet-based strategies are the most widely used
options. Unfortunately, these last remain recommended on the basis of empirical or
not widely validated evidence. Therefore, given the exponential rise of TAVR and TMVR
procedures, it is important to identify the optimal antithrombotic strategies that
best fit the risk of thromboembolic and bleeding events. Hereafter, this review evaluates
the current guidelines, trials, and observational data discussing antithrombotic strategy
after transcatheter aortic or mitral valve replacement.
Keywords
transcatheter heart valve replacement - antithrombotic therapy - valve thrombosis
