Di Muro Francesca Maria, Vogel Birgit, Oliva Angelo, Bay Benjamin, Gitto Mauro, Dangas George D, Mehran Roxana
Zena and Michael A. Wiener Cardiovascular Institute Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Structural Interventional Cardiology Unit, Careggi University Hospital, Florence, Italy.
Struct Heart. 2024 Nov 22;9(7):100360. doi: 10.1016/j.shj.2024.100360. eCollection 2025 Jul.
Over the past 2 decades, structural heart interventions-including procedures like transcatheter aortic valve replacement, transcatheter mitral or tricuspid valve replacement, and transcatheter edge-to-edge mitral or tricuspid valve repair-have emerged as feasible alternatives to traditional surgery for treating valvular heart diseases. Antithrombotic treatment represents a critical aspect of postoperative care, aiming to balance the thromboembolic risk due to the incorporation of prosthetic materials and the consequently altered hemodynamics within the cardiac chambers with the bleeding risk depending on patients' and procedural factors. This continuously evolving interplay underscores the importance of personalized, evidence-based approaches to ensure optimal outcomes. This review provides a comprehensive examination of the current knowledge on antithrombotic therapies after structural interventions, offering insights into the evolving field and emphasizing the importance of tailored strategies.
在过去20年中，结构性心脏介入治疗——包括经导管主动脉瓣置换术、经导管二尖瓣或三尖瓣置换术以及经导管二尖瓣或三尖瓣缘对缘修复术等——已成为治疗心脏瓣膜疾病的传统手术的可行替代方案。抗栓治疗是术后护理的一个关键方面，旨在平衡因植入人工材料以及心腔内血流动力学改变而导致的血栓栓塞风险与取决于患者和手术因素的出血风险。这种不断演变的相互作用凸显了个性化、循证方法以确保最佳结果的重要性。本综述全面审视了结构性介入治疗后抗栓治疗的现有知识，深入探讨了这一不断发展的领域，并强调了个性化策略的重要性。
