Transcatheter aortic valve implantation (TAVI) is all the more used therapeutic option for patients suffering
from symptomatic severe aortic valvular stenosis declined by surgeons because of high surgical risk. Given
the high bleeding and ischemic risk of this vulnerable population, their antithrombotic treatment becomes a crucial
issue. There is no consensus on antithrombotic treatment after TAVI and dual antiplatelet therapy (DAPT) with aspirin
(indefinitely) and clopidogrel (1-6 months) is, in general, recommended. With regards to patients with an
indication for oral anticoagulation (OAC), a combination of OAC plus aspirin or clopidogrel is commonly
suggested. This review underscores that it is extremely difficult to compare different antithrombotic regimens in
patients undergoing TAVI because of their variable demographic characteristics. Nevertheless, available data suggest
that DAPT results to more bleeding events. Still, whether it positively affects ischemic episodes is doubtful. Ongoing trials are expected
to draw a clearer picture on the field.
Keywords: TAVR, PAVI, PAVR, bioprosthesis, anticoagulation, OAC, clopidogrel, aspirin.
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