PMID- 28391560
OWN - NLM
STAT- MEDLINE
DCOM- 20180101
LR  - 20181113
IS  - 1534-3170 (Electronic)
IS  - 1523-3782 (Linking)
VI  - 19
IP  - 5
DP  - 2017 May
TI  - Adjuvant Antithrombotic Therapy in TAVR.
PG  - 41
LID - 10.1007/s11886-017-0850-1 [doi]
AB  - PURPOSE OF REVIEW: Transcatheter aortic valve replacement (TAVR) has developed 
      into an important alternative to surgical aortic valve replacement (SAVR) for 
      patients with severe aortic stenosis (AS). Adjuvant antithrombotic therapies are 
      commonly used during and after TAVR to decrease the risk of valve thrombosis and 
      thromboembolic cerebrovascular events (CVEs) but consequently increase the risk 
      of bleeding. This article reviews the past and current clinical data regarding 
      adjuvant antithrombotic therapies in TAVR. RECENT FINDINGS: Cerebrovascular and 
      bleeding events during and after TAVR are associated with substantial morbidity 
      and mortality. Bivalirudin, a direct thrombin inhibitor, has been shown to be 
      safe alternative to unfractionated heparin (UFH) as procedural anticoagulation 
      during TAVR; however, sparse evidence exists to guide use of antiplatelet and 
      anticoagulant therapies in patients after TAVR. Multiple studies comparing 
      different antithrombotic regimens in the post-TAVR setting are currently 
      underway. Current guidelines recommend intra-procedural anticoagulation with UFH 
      for during TAVR and with dual antiplatelet therapy (DAPT) after TAVR. There is a 
      need to better understand the role of adjuvant antithrombotic therapies in TAVR. 
      The results of ongoing studies are needed to develop evidence-based guidance for 
      the use of adjuvant antithrombotic therapies after TAVR.
FAU - O'Malley, Ryan G
AU  - O'Malley RG
AD  - Falk Cardiovascular Research Center, Stanford University School of Medicine, 870 
      Quarry Road, Stanford, CA, 94305, USA. romalley@stanford.edu.
FAU - Mahaffey, Kenneth W
AU  - Mahaffey KW
AD  - Department of Medicine, Division of Cardiovascular Medicine, Stanford Center for 
      Clinical Research, Stanford University School of Medicine, 300 Pasteur Drive, 
      Grant S102, Stanford, CA, 94305, USA.
FAU - Fearon, William F
AU  - Fearon WF
AD  - Department of Medicine, Division of Cardiovascular Medicine, Stanford University 
      School of Medicine, 300 Pasteur Drive, Room A260 MC:5319, Stanford, CA, 94305, 
      USA.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Cardiol Rep
JT  - Current cardiology reports
JID - 100888969
RN  - 0 (Anticoagulants)
RN  - 0 (Fibrinolytic Agents)
SB  - IM
MH  - Anticoagulants/*therapeutic use
MH  - Aortic Valve Stenosis/*drug therapy/*surgery
MH  - Chemotherapy, Adjuvant/*methods
MH  - Fibrinolytic Agents/therapeutic use
MH  - Humans
MH  - Perioperative Care/*methods
MH  - Practice Guidelines as Topic
MH  - Transcatheter Aortic Valve Replacement/adverse effects/*methods
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Anticoagulant
OT  - Antiplatelet
OT  - Aortic stenosis (AS)
OT  - Bleeding
OT  - Stroke
OT  - Transcatheter aortic valve replacement (TAVR)
EDAT- 2017/04/10 06:00
MHDA- 2018/01/02 06:00
CRDT- 2017/04/10 06:00
PHST- 2017/04/10 06:00 [entrez]
PHST- 2017/04/10 06:00 [pubmed]
PHST- 2018/01/02 06:00 [medline]
AID - 10.1007/s11886-017-0850-1 [pii]
AID - 10.1007/s11886-017-0850-1 [doi]
PST - ppublish
SO  - Curr Cardiol Rep. 2017 May;19(5):41. doi: 10.1007/s11886-017-0850-1.