Nusca Annunziata, Bressi Edoardo, Colaiori Iginio, Miglionico Marco, Di Sciascio Germano
Unit of Cardiac Sciences, Campus Bio-Medico University of Rome, Rome, Italy.
Cardiovasc Diagn Ther. 2018 Oct;8(5):678-693. doi: 10.21037/cdt.2018.06.08.
Transcatheter interventions for valvular and structural heart diseases are rapidly expanding due to greater operators' experience and development of new generation devices associated with increased procedural safety. They represent the standard strategy for patients with prohibitive risk for open surgery. These procedures are associated with a significant occurrence of both thrombotic and bleeding complications, thus in this setting, even more than in other percutaneous procedures, the balance between thrombotic and bleeding risk is critical. This review describes the current data available on the antithrombotic management of patients undergoing transcatheter aortic valve implantation (TAVI), percutaneous mitral valve repair with the MitraClip system, percutaneous left atrial appendage occlusion and percutaneous patent foramen ovale (PFO)/atrial septal defects (ASD) closure.
由于术者经验的增加以及新一代设备的研发（这与手术安全性的提高相关），经导管介入治疗瓣膜性和结构性心脏病正在迅速发展。对于接受心脏直视手术风险过高的患者，经导管介入治疗是标准策略。这些手术与血栓形成和出血并发症的显著发生相关，因此在这种情况下，与其他经皮手术相比，血栓形成风险和出血风险之间的平衡更为关键。本综述描述了目前关于接受经导管主动脉瓣植入术（TAVI）、使用MitraClip系统进行经皮二尖瓣修复、经皮左心耳封堵以及经皮卵圆孔未闭（PFO）/房间隔缺损（ASD）封堵患者的抗栓治疗管理的可用数据。
