TAVI is the standard procedure for patients with symptomatic severe aortic stenosis and increased surgical risk.
TAVI patients are at high risk of embolic and bleeding complications.
The mechanisms of valve thrombosis after TAVI are multifactorial: flow disturbances, stent structure, older population with comorbidities.
The optimal peri-procedural and long-term antithrombotic prophylaxis, remain unclear. European and AHA guidelines based on expert consensus recommend aspirin (ASA) and clopidogrel for 3-6 (ESC) or 6 (AHA) months and ASA life-long.
Only in ESC, SAPT may be considered in case of high bleeding risk. In patients with AF or other indication for oral anticoagulation (OAC), the continuation of OAC is recommended.
Ongoing randomized studies (ATLANTIS, GALILEO, ENVISAGE-TAVI AF) will show the role of direct oral antagonist not only in patients with AF but also in sinus rhythm.
Resources below have been selected by Dr. Katarzyna Czerwinska
Acute Cardiovascular Care Congress Resources
Access the session from Acute Cardiovascular Care 2019
ESC Congress 2018
- Maintenance of anti-thrombotic therapy after TAVI
- Prevention and treatment of bioprosthetic valve failure
- Leaflet thrombosis following bioprosthetic valve replacement: storm in a teacup?
European Heart Journal - Acute Cardiovascular Care
Access a selection of relevant scientific papers in the field
Topic on Bleeding and haemostatis disorders