Valvo Roberto, Costa Giuliano, Tamburino Corrado, Barbanti Marco
Division of Cardiology, Policlinico-Vittorio Emanuele Hospital, University of Catania, Catania, Italy.
Front Cardiovasc Med. 2019 May 31;6:73. doi: 10.3389/fcvm.2019.00073. eCollection 2019.
Transcatheter aortic valve replacement (TAVR) has recently emerged as an effective alternative to medical treatment or surgical aortic valve replacement in all symptomatic patients with severe aortic stenosis and high or prohibitive risk and in intermediate risk when transfemoral access is feasible. Patients undergoing TAVR are often at high risk for either bleeding or cerebrovascular complications, or both, so adjuvant antithrombotic therapies are commonly used before, during and after the procedure. Today, there is no clear evidence on the best antithrombotic regimen in this context. In this review, we will try to go through the mechanisms involved in bleeding and embolic complications and we will discuss the current points of antithrombotic treatment in patients during and after TAVR, with or without oral anticoagulation (OAC) indication.
经导管主动脉瓣置换术（TAVR）最近已成为所有有症状的严重主动脉瓣狭窄且手术风险高或禁忌的患者以及在可行经股动脉入路时中度风险患者的一种有效替代药物治疗或外科主动脉瓣置换术的方法。接受TAVR的患者通常有出血或脑血管并发症的高风险，或两者皆有，因此在手术前、手术期间和手术后通常使用辅助抗栓治疗。目前，在这种情况下，尚无关于最佳抗栓方案的确切证据。在本综述中，我们将探讨出血和栓塞并发症的相关机制，并讨论TAVR手术期间及术后有或无口服抗凝（OAC）指征患者的抗栓治疗现状。
