title: [Antithrombotic therapy in patients undergoing transcatheter aortic valve implantation].
abstract: Transcatheter aortic valve implantation (TAVI) has emerged as a valid alternative to surgical replacement in patients with severe aortic stenosis. Bleeding and cerebral ischemic events remain frequent complications of this procedure during the periprocedural period and at follow-up with a severe impact on survival. Therefore, there is growing interest towards the optimal antithrombotic therapy to manage patients undergoing TAVI. International guidelines support the adoption of a dual antiplatelet therapy after TAVI, although there is heterogeneity in the suggested duration and the concomitant association with an oral anticoagulant in patients with specific indications, mainly those with atrial fibrillation. Recent data have questioned the benefits of adding clopidogrel to aspirin, showing a slight increase in bleeding compared with aspirin therapy alone. Importantly, recent studies have also underlined the risks of valve thrombosis and the potential benefits of oral anticoagulant therapy in patients undergoing TAVI. Currently, large randomized trials are ongoing and are expected to provide relevant information to guide recommendations on the most appropriate antithrombotic therapy in these patients. Tailored therapy based on the patient's risk profile remains relevant in daily clinical practice.
authors.affiliation: Department of Cardiology, Inselspital, University of Bern, Berna, Svizzera.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gargiulo
authors.affiliation: Department of Cardiology, Inselspital, University of Bern, Berna, Svizzera.
authors.forename: Marco
authors.initials: M
authors.lastname: Valgimigli
mesh_terms: D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000628:therapy*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006350:Heart Valve Prosthesis; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D065467:Transcatheter Aortic Valve Replacement; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors