Antithrombotic Therapy in Patients Undergoing Transcatheter Interventions for Structural Heart Disease

被引:54
作者
Calabro, Paolo [1 ,2 ]
Gragnano, Felice [1 ,2 ]
Niccoli, Giampaolo [3 ,4 ,5 ]
Marcucci, Rossella [6 ]
Zimarino, Marco [7 ]
Spaccarotella, Carmen [8 ]
Renda, Giulia [7 ]
Patti, Giuseppe [9 ]
Ando, Giuseppe [10 ]
Moscarella, Elisabetta [1 ,2 ]
Mancone, Massimo [11 ]
Cesaro, Arturo [1 ,2 ]
Giustino, Gennaro [12 ]
De Caterina, Raffaele [13 ,14 ]
Mehran, Roxana [12 ]
Capodanno, Davide [15 ,16 ]
Valgimigli, Marco [17 ,18 ]
Windecker, Stephan [18 ]
Dangas, George D. [12 ]
Indolfi, Ciro [8 ,19 ]
Angiolillo, Dominick J. [20 ]
机构
[1] Univ Campania Luigi Vanvitelli, Dept Translat Med Sci, I-80131 Naples, Italy
[2] AORN St Anna & San Sebastiano, Div Cardiol, Caserta, Italy
[3] Fdn Policlin Univ A Gemelli IRCCS, Dept Cardiovasc Med, Rome, Italy
[4] Univ Cattolica Sacro Cuore, Dept Cardiovasc & Pulm Sci, Rome, Italy
[5] Univ Parma, Dept Med, Parma, Italy
[6] Univ Florence, Dept Expt & Clin Med, Florence, Italy
[7] Univ G DAnnuzio Chieti Pescara, Inst Cardiol, Chieti, Italy
[8] Magna Grecia Univ, Dept Med & Surg Sci, Catanzaro, Italy
[9] Univ Piemonte Orientale, Maggiore Carita Hosp, Dept Translat Med, Via Solaroli, Novara, Italy
[10] Univ Messina, Dept Clin & Expt Med, Unit Cardiol, Messina, Italy
[11] Sapienza Univ Rome, Dept Clin Internal Anesthesiol & Cardiovasc Sci, Rome, Italy
[12] Icahn Sch Med Mt Sinai, Zena & Michael A Wiener Cardiovasc Inst, New York, NY 10029 USA
[13] Univ Pisa, Pisa Univ Hosp, Univ Cardiol Div, Pisa, Italy
[14] Citta St Angelo, Fdn Villa Serena Ric, Pisa, Italy
[15] Ctr Alte Specialita & Trapianti, Cardiothorac Vasc Dept, Catania, Italy
[16] Univ Catania, Azienda Osped Univ Policlin G Rodolico San Marco, Catania, Italy
[17] Ente Osped Cantonale, Cardioctr Ticino Inst, Lugano, Switzerland
[18] Univ Bern, Bern Univ Hosp, Dept Cardiol, Bern, Switzerland
[19] Mediterranea Cardioctr, Naples, Italy
[20] Univ Florida, Coll Med, Div Cardiol, Jacksonville, FL USA
关键词
anticoagulants; atrial appendage; atrial fibrillation; foramen ovale; patent; mitral valve; thrombosis; transcatheter aortic valve replacement; LEFT ATRIAL APPENDAGE; PATENT FORAMEN OVALE; AORTIC-VALVE-REPLACEMENT; DUAL ANTIPLATELET THERAPY; ACADEMIC RESEARCH CONSORTIUM; CLINICAL FRAILTY SCALE; VITAMIN-K ANTAGONISTS; HIGH BLEEDING RISK; PERCUTANEOUS CLOSURE; EUROPEAN ASSOCIATION;
D O I
10.1161/CIRCULATIONAHA.121.054305
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Contemporary evidence supports device-based transcatheter interventions for the management of patients with structural heart disease. These procedures, which include aortic valve implantation, mitral or tricuspid valve repair/implantation, left atrial appendage occlusion, and patent foramen ovale closure, profoundly differ with respect to clinical indications and procedural aspects. Yet, patients undergoing transcatheter cardiac interventions require antithrombotic therapy before, during, or after the procedure to prevent thromboembolic events. However, these therapies are associated with an increased risk of bleeding complications. To date, challenges and controversies exist regarding balancing the risk of thrombotic and bleeding complications in these patients such that the optimal antithrombotic regimens to adopt in each specific procedure is still unclear. In this review, we summarize current evidence on antithrombotic therapies for device-based transcatheter interventions targeting structural heart disease and emphasize the importance of a tailored approach in these patients.
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收藏
页码:1323 / 1343
页数:21
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