Lugo Leslie Marisol, Romaguera Rafael, Gómez-Hospital Joan Antoni, Ferreiro José Luis
Dobney Hypertension Centre, School of Medicine - Royal Perth Hospital Unit/Medical Research Foundation, University of Western Australia, Perth, Australia.
Heart Diseases Institute, Hospital Universitario de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
Eur Cardiol. 2020 Feb 26;15:1-8. doi: 10.15420/ecr.2019.10. eCollection 2020 Feb.
The development of transcatheter aortic valve implantation has represented one of the greatest advances in the cardiology field in recent years and has changed clinical practice for patients with aortic stenosis. Despite the continuous improvement in operators' experience and techniques, and the development of new generation devices, thromboembolic and bleeding complications after transcatheter aortic valve implantation remain frequent, and are a major concern due to their negative impact on prognosis in this vulnerable population. In addition, the optimal antithrombotic regimen in this scenario is not known, and current recommendations are mostly empirical and not evidence based. The present review aims to provide an overview of the current status of knowledge, including relevant on-going randomised trials, on antithrombotic treatment strategies after transcatheter aortic valve implantation.
经导管主动脉瓣植入术的发展是近年来心脏病学领域最重大的进展之一,改变了主动脉瓣狭窄患者的临床治疗方式。尽管术者经验和技术不断提高,新一代器械也不断发展,但经导管主动脉瓣植入术后血栓栓塞和出血并发症仍然频发,鉴于其对这一脆弱人群预后的负面影响,这些并发症成为主要关注点。此外,这种情况下的最佳抗栓方案尚不清楚,目前的推荐大多基于经验而非证据。本综述旨在概述经导管主动脉瓣植入术后抗栓治疗策略的当前知识状况,包括相关正在进行的随机试验。