While surgical aortic valve replacement (SAVR) was for years the only available treatment for symptomatic
aortic stenosis, the introduction of transcatheter aortic valve implantation (TAVI) in 2002 and the improvement
of its technical aspects in the following years, has holistically changed the synchronous therapeutic
approach of aortic valve stenosis. Recent evidence has expanded the indication of TAVI from high to lower surgical
risk populations with symptomatic aortic stenosis. The administration of antithrombotic therapy periprocedurally
and its maintenance after a successful TAVI is crucial for the prevention of complications and affects
postprocedural survival. Randomized controlled trials investigating the appropriate combination and the
duration of antithrombotic treatment after TAVI are for the moment scarce. This review article sheds light on the
underlying pathogenetic mechanisms contributing in periprocedural TAVI thrombotic complications and discuss
the efficacy of current antithrombotic policies as evaluated in randomized trials.
Keywords: TAVI, antithrombotic therapy, DAPT, NOAC, VKA, SAVR.
Mahmaljy H, Young M. Transcatheter Aortic Valve Replacement (TAVR/TAVI, Percutaneous Replacement). StatPearls Publishing 2019.
Paul S, Aziz M, Bad Nauheim K-K, et al. Matched Comparison of Self-Expanding Transcatheter Heart Valves for the Treatment of Failed Aortic Surgical Bioprosthesis Insights From the Valve-in-Valve International Data Registry (VIVID). Structural Heart Disease 2017.
Pascual I, Avanzas P, Muñoz-García AJ, et al. Percutaneous implantation of the CoreValve® self-expanding valve prosthesis in patients with severe aortic stenosis and porcelain aorta: medium-term follow-up. Rev Española Cardiol (English Ed) 2013; 66: 775-81.
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